A Clinical and Roentgenographic Study of Little League Elbow

Hang, David; Chao, Chien Ming; Hang, Yi‐Shiong

doi:10.1177/0095399703258674

Cited by 159 publications

(88 citation statements)

References 13 publications

(26 reference statements)

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“…Furthermore, 85.2% of subjects who underwent radiographic examination showed abnormal signs on radiographs. Our results were almost equivalent to the previous report by Matsuura et al (6) Hang et al (4) reported that 52% of young baseball players (mean age, 11.6 years ; range, 9.5 -12.0 years) had episodes of soreness of the throwing elbow. The reason why our results (31.1%) were lower than that reported by Hang et al (4) was that our study included all elementary school students (mean age, 10.1 years ; range, 6 -12 years) in contrast to their study.…”

Section: Discussionsupporting

confidence: 91%

Outcome of an elbow check-up system for child and adolescent baseball players

et al. 2016

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INTRODUCTIONBaseball is one of the most popular sports in the world. Although baseball is relatively safe, numerous reports suggested that there has been a rapid rise in injury rates among youth baseball players (1 -4). It is important to demonstrate the nature of such injuries. In Tokushima, we started a check-up for child and adolescent baseball players in the field from 1981. From the findings of the checkup, we investigated the frequency of pain in each part of the body. The most frequent area of pain was the elbow joint, which was found in about 30% of players (5). Matsuura et al. (6) followed 449 youth baseball players without prior elbow pain for one season and reported that 30% of youth players had elbow pain each year, and nearly 72.3% of players with elbow pain had abnormal findings on physical examination such as limitation in the range of motion, tenderness, and pain on valgus stress test. Furthermore, 81.4% of the subjects with abnormal findings on physical examination exhibited radiographic abnormalities : medial epicondylar fragmentation was observed in 97.2% and osteochondritis dissecans (OCD) of the capitellum was seen in 2.8%. Hang et al. (4) reported results that were similar to our findings. They explained that 52% of the 343 Taiwanese Little League baseball players (mean age, 11.6 years ; range, 9.5-12.0 years) had episodes of soreness of the throwing elbow. Radiographic examination of all players revealed separation or fragmentation of the medial epicondyle in 76% and OCD of the capitellum in only 1 catcher. Although medial epicondylar fragmentation was prevalent in either report, the prognosis of medial epicondylar fragmentation is relatively good (7,8). By contrast, the prognosis of OCD of the capitellum is often poor. However, it was difficult to detect OCD of the capitellum based on subjective complaints and physical examination, because most players with OCD of the capitellum were asymptomatic or minimally symptomatic. Ultrasound imaging, which does not involve exposure to radiation, is inexpensive, and is a portable type of diagnostic imaging, is useful for detecting OCD of the capitellum. Harada et al. (9) found 33 subjects with medial epicondylar fragmentation (21.6%) and 2 with OCD of the capitellum (1.3%) among 153 players aged 9 to 12 years using ultrasound imaging in the field. Matsuura et al. (10) reported that the prevalence of OCD of the capitellum on ultrasonography in 1040 young baseball players aged 10 to 12 years was 2.1%.The purpose of this study was to report the outcome of an elbow check-up system for child and adolescent baseball players in 2013. In particular, we investigated the situation of elbow injuries in youth baseball players with elbow pain and ultrasonographic findings of the capitellum in all players. MATERIALS AND METHODSThe Institutional Review Board of Tokushima University Hospital approved the study protocol, and all parents and coaches provided informed consent.A total of 1605 players (mean age, 10.1 years ; range, 6 -12 years) ORIGINALOutcome of an...

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Section: Discussionsupporting

confidence: 91%

Outcome of an elbow check-up system for child and adolescent baseball players

et al. 2016

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“…As some authors place chronic elbow pain of all causes in young throwing athletes under this denominator, little leaguer elbow is regarded as a traction apophysitis of the medial epicondyle mostly occurring in the 9-14-year-old age group due to repetitive valgus stress [14]. Radiographic examination can be completely normal or show subtle widening of the physis or fragmentation of the apophysis, although these findings are also described in athletes without complaints [15]. Often MRI is necessary to confirm the diagnosis and exclude differentials.…”

Section: Osseous and Growth Cartilage Injuriesmentioning

confidence: 99%

Sport injuries in the paediatric and adolescent patient: a growing problem

et al. 2009

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With an increasing number of paediatric and adolescent athletes presenting with injuries due to overuse, a greater demand is put on clinicians and radiologists to assess the specific type of injury. Repetitive forces applied to the immature skeleton cause a different type of injury than those seen in adults due to the differences in vulnerability of the musculoskeletal system, especially at the site of the growth cartilage. Intrinsic and extrinsic risk factors all play a role in the development of overuse injuries. MRI plays a key role in imaging overuse injuries due to its high potential for depicting cartilaginous and softtissue structures. Sport-specific biomechanics are described, since this knowledge is essential for adequate MRI assessment. An overview of several sport-related injuries is presented, based on anatomical location.

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“…The mean age of the patients in our study (15.72 years) is higher than that of the patients from the studies by Adams and Hang et al (9,10) We specifically chose patients aged 15-17 years as we believed that there would not be any further bony changes to the medial epicondyle during that age range, especially after years of traction injuries to the elbow. With the epiphysis closed, it would be easier to identify all the bony landmarks and thus ensure that measurements of the medial epicondyle are accurate.…”

Section: Discussionmentioning

confidence: 84%

“…(9,10) In both these studies, the authors evaluated the radiographs of their patients' elbows in anteroposterior view and the age range of their study cohorts were wide, at 9-14 years.…”

Section: Discussionmentioning

confidence: 99%