Open Reduction Internal Fixation of Medial Epicondyle Fractures After Ulnar Collateral Ligament Reconstruction in Professional Baseball Pitchers

Erickson, Brandon J.; Chalmers, Peter N.; D’Angelo, John; Ma, Kevin; Romeo, Anthony A.

doi:10.1177/2325967119852896

Cited by 7 publications

(3 citation statements)

References 28 publications

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“…Performance data were analyzed as previously described with this data set. 5,9 Preoperative and postoperative data were then compared using the paired Student t test and related-samples Wilcoxon signed-rank test as appropriate based on data normality. For each player, maximum preoperative and postoperative levels of play were determined, and each player was then determined to have either returned to the same or a higher level of play, returned but to a lower level of play, or not have returned to play.…”

Section: Methodsmentioning

confidence: 99%

Performance and Return to Sports After Meniscectomy in Professional Baseball Players

et al. 2022

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Background: Meniscal injuries are common in athletes across many sports. How professional baseball players respond to partial meniscectomy is not well documented. Purpose/Hypothesis: The purpose was to determine the performance and return-to-sports (RTS) rate in professional baseball players after arthroscopic partial knee meniscectomy and compare the results of partial medial meniscectomy versus partial lateral meniscectomy. The hypothesis was that there would be a high RTS rate in professional baseball players after partial meniscectomy with no difference in the RTS rate or timing of RTS between players who underwent partial medial meniscectomy versus partial lateral meniscectomy. Study Design: Cohort study; Level of evidence, 3. Methods: All professional baseball players who underwent arthroscopic partial meniscectomy between 2010 and 2017 were identified using the Major League Baseball Health and Injury Tracking System database. Demographic and performance data (before and after injury) for each player were recorded. The RTS rate and timing of RTS were then compared between players who underwent partial medial meniscectomy versus partial lateral meniscectomy. Results: A total of 168 knees (168 players) underwent arthroscopic partial meniscectomy (mean age, 25 ± 5 years; 46% medial meniscectomy, 45% lateral meniscectomy, and 9% both medial and lateral meniscectomy). The most common mechanism of injury was fielding in the infield on natural grass. Injuries were spread evenly across positions: 18% catchers, 24% infielders, 20% outfielders, and 38% pitchers. The overall RTS rate was 80% (76% returned to the same or a higher level, and 4% returned to a lower level). For performance, pitchers saw significant decreases in usage but significant improvements in performance using the advanced statistics of fielding independent pitching ( P < .001) and wins above replacement ( P = .011). Hitters saw significant decreases in usage but increases in efficiency as seen by improvements in wins above replacement ( P = .003). Of the 79 athletes who returned during the same season, the median time to return to play was 42 days. Conclusion: The RTS rate after meniscectomy in professional baseball players was 80%. Player efficiency improved after surgery in pitchers and position players. No difference in the RTS rate or timing of RTS existed between players who underwent partial medial meniscectomy versus partial lateral meniscectomy.

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Section: Methodsmentioning

confidence: 99%

Performance and Return to Sports After Meniscectomy in Professional Baseball Players

et al. 2022

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“…15 HITS has been used in several previous studies and has been found to be a reliable source of information. 2,4,5,9,10 The second dataset was a record of player usage between 2011 and 2017. Each player was assigned a unique ID, linking the 2 datasets.…”

Section: Methodsmentioning

confidence: 99%

Is Workload Associated With Hamstring and Calf Strains in Professional Baseball Players? An Analysis of Days of Rest, Innings Fielded, and Plate Appearances

Chalmers

Mcelheny

D’Angelo

et al. 2022

Sports Health: A Multidisciplinary Approach

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Background: The influence of player workload on hamstring and calf injuries in professional baseball players remains unknown. Hypothesis: Increased workload would significantly increase hamstring and calf strain injury risk. Study Design: Case-control. Level of Evidence: Level 3. Methods: All professional baseball players who sustained a hamstring or calf injury between 2011 and 2017 were identified using the Major League Baseball (MLB) Health and Injury Tracking System (HITS). A separate player usage dataset was used to determine workload. We then compared these variables between player games 2, 6, 12, and >12 weeks before a documented calf strain to player games from a noncalf injury control group. In a paired analysis, we compared the acute workload (2, 6, and 12 weeks) before injury with the injured player’s workload >12 weeks before injury. Results: There were 175 unique calf strains (71% occurred in position players) and 1042 unique hamstring strains (97.8% occurred in position players) documented in the MLB HITS database from 2011 to 2017. In all time periods, position players with fewer days rest, more innings fielded, and more plate appearances were associated with a higher risk of subsequent hamstring and calf strains. Having only 1 day rest was associated with a 2.08-fold increase in percentage of players who sustained a subsequent calf strain compared with those with 4 days rest. Position players with >5 days of rest had a 4.03-fold decrease in percentage of players who sustained a hamstring strain compared with players with 1 day rest. Position players who fielded >9 innings per game had a 2.01-fold increase in percentage of players with a subsequent calf strain and a 3.68-fold increase in percentage of players who sustained a subsequent hamstring strain compared with players who only fielded 1 innings per game. Conclusion: Position players with fewer days rest, more innings fielded, and more plate appearance per game had an increased risk of sustaining a hamstring or calf injury. Clinical Relevance: Increased workload had a direct relationship with risk of hamstring and calf strains in professional baseball players. Teams should consider more days rest for position players to avoid calf injuries.

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“…Relative indications are controversial and can include concomitant ulnar nerve dysfunction, associated elbow dislocation, significant fracture fragment displacement, and injuries in high-level throwing athletes. Erickson et al 6 studied the return to play and performance of professional baseball pitchers after ORIF of the medial epicondyle, seen as a sequela after ulnar collateral ligament reconstruction. They found that 73% were able to return to sport; however, only 55% were able to pitch at the same level or higher.…”

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Clinical Outcomes and Return to Play in Youth Overhead Athletes After Medial Epicondyle Fractures Treated With Open Reduction and Internal Fixation

Cain

Liesman²,

Fleisig

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: There is limited literature regarding outcomes after operative treatment of displaced medial epicondyle avulsion fractures in adolescent athletes. Most studies have had a relatively small sample size and have not assessed return to play of the overhead athlete. Purpose: To examine return to play and outcomes of youth overhead athletes who underwent open reduction and internal fixation (ORIF) with screw fixation. Study Design: Case series; Level of evidence, 4. Methods: Charts and radiographs were queried between January 2003 and June 2018 for young overhead athletes (age, <17 years) who underwent ORIF for displaced medial epicondyle fracture. Patients with open fracture or concomitant injury were excluded. Radiographs from postoperative follow-up visits were examined for radiographic union. Eligible patients were asked to provide responses to the American Shoulder and Elbow Surgeons Standardized Assessment Elbow questionnaire and Kerlan-Jobe Orthopaedic Clinic questionnaires as well as questions regarding return to play. Results: Overall, 29 patients were included in the study; the mean age at surgery was 14.7 years (range, 12.9-16.5 years). There were 25 baseball players, 3 football quarterbacks, and 1 tennis player. Of the 23 patients with available images at least 3 months after surgery, 96% demonstrated radiographic union at last follow-up. Imaging for the 1 patient with nonunion was taken 3 months after ORIF, and it is unknown if he eventually had union. All patients (100%) were successfully contacted to complete questionnaires at a mean follow-up of 4.8 years (range, 1.0-13.5 years). The mean KJOC score was 93.0, and the mean scores for the American Shoulder and Elbow Surgeons Elbow questionnaire were 8.9, 35.6, and 9.8 for pain, function, and satisfaction, respectively. One overhead athlete did not return to play, while the other 28 returned at a mean 7 months after surgery. No patient underwent revision ORIF, 1 underwent hardware removal, and 1 underwent ulnar nerve transposition. No players underwent ulnar collateral ligament reconstruction after primary ORIF of the medial epicondyle. Conclusion: ORIF of displaced medial epicondyle fractures is a reliable and successful procedure in adolescent overhead athletes with high demands, with relatively low risk of major complications, reinjury, or reoperation.

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Open Reduction Internal Fixation of Medial Epicondyle Fractures After Ulnar Collateral Ligament Reconstruction in Professional Baseball Pitchers

Cited by 7 publications

References 28 publications

Performance and Return to Sports After Meniscectomy in Professional Baseball Players

Performance and Return to Sports After Meniscectomy in Professional Baseball Players

Is Workload Associated With Hamstring and Calf Strains in Professional Baseball Players? An Analysis of Days of Rest, Innings Fielded, and Plate Appearances

Clinical Outcomes and Return to Play in Youth Overhead Athletes After Medial Epicondyle Fractures Treated With Open Reduction and Internal Fixation

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