Surgical repair of traumatic medial disruption of the elbow in competitive athletes.

Inoue, Goro; Kuwahata, Yoshio

doi:10.1136/bjsm.29.2.139

Cited by 17 publications

(5 citation statements)

References 6 publications

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“…Only one study with a small sample size highlights an early surgical repair of the medial ligament and flexor mass in athletes to be superior. All athletes (four motocross, one volleyball) regained full articular function and stability of the elbow and were able to resume their previous sporting activities, however, a conclusive statement is hard to be drawn due to the small sample [9]. Evidently, the current study shows beside satisfactory patient outcomes still that for 10 % of participants, the performance level is greatly reduced, and one participant even reported the carrer ending due to the injury.…”

Section: Level Of Performancementioning

confidence: 56%

“…Evidently, the current study shows beside satisfactory patient outcomes still that for 10 % of participants, the performance level is greatly reduced, and one participant even reported the carrer ending due to the injury. Thus, future efforts should focus on the identification of patients who would benefit from surgical treatment [9,16].…”

Section: Level Of Performancementioning

confidence: 99%

“…However, controversy exists regarding the treatment of highperformance patients, such as elite athletes [6]. Despite a lack of evidence, some authors recommend surgery following acute simple elbow dislocation for elite athletes who participate in arm-demanding sports in order to restore original anatomy and achieve stable healing [9,10]. Contrarily, Chang et al and Gibbs et al reported that the majority of elbow dislocations in high-level athletes in the American National Football League (NFL) were successfully treated non-operatively, representing the only study on elite contact athletes to date [11,12].…”

Section: Introductionmentioning

confidence: 99%

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Return to sport after conservative treatment of elbow dislocation in judoka

Lambert

Ritzmann

Geßlein

et al. 2023

Sportverletz Sportschaden

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Background Injuries to the elbow are frequent in judo combat, but studies on down-time and effect on performance after conservative treatments are rare. This issue is particularly relevant for elbow dislocations in high-performance patients such as elite athletes. The purpose of this study was to evaluate (1) time-loss and (2) the regained level of performance in judoka after conservative treatment of simple elbow dislocation. Methods In cooperation with the European Judo Union, judoka were asked to complete a 139-item survey regarding elbow injuries they suffered during their career. Besides demographics, injury data, diagnosis and treatment options, the athletes were asked about down-time and reductions in performance level. This study enrolled 108 judoka with conservative treatment of elbow dislocation out of a population of 5426 volunteers. Results 69% (n=74) reported a time-loss of less than three months; 6% reported a time-loss of more than six months. The majority (68%, n=73) reported that they had returned to their previous performance level, while 22% (n=24) suffered from a slightly reduced level of performance. In the subgroup of international and national athletes (n=54), 63% returned to judo after less than three months, with 72% achieving the same level and 15% reporting a slightly reduced performance level. Level of performance and time lost after conservative treatment for elbow dislocations were comparable for male and female judoka. Conclusion Approximately two out of three judoka returned to the same level of performance after three months of down-time after undergoing conservative therapy for simple elbow dislocations. Despite the high performance level of the study population, conservative treatment of simple elbow dislocation resulted in satisfactory outcomes. The presented data can guide medical professionals and competitive-level contact-sport athletes with respect to expectations in the process of returning to sport.

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Section: Level Of Performancementioning

confidence: 56%

Section: Level Of Performancementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Return to sport after conservative treatment of elbow dislocation in judoka

Lambert

Ritzmann

Geßlein

et al. 2023

Sportverletz Sportschaden

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show abstract

“…[6][7][8]11,16 Kenter et al 8 recommended conservative management, whereas others recommended the primary repair of medial structures. 6,11,16 Inoue and Kuwahata 6 emphasized that early surgical repair of the MCL and FPT should be considered for active athletes who exhibit gross instability of the elbow on a valgus stress test without general anesthesia. Although there were no definite operative indications of acute valgus instability, our patients had high-grade instability; the mean difference in opening of the medial joint space was 11.1 mm on valgus stress radiographs with complete disruption of the FPT on MRI.…”

Section: Discussionmentioning

confidence: 98%

Acute severe valgus instability without elbow dislocation

Cho¹,

Bae²,

Ye³

et al. 2015

Journal of Shoulder and Elbow Surgery

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“…Although the current treatment strategy of acute traumatic valgus instability has been still in controversy, most literature advocated primary repair of the anatomical stabilizers maintaining valgus stability of the elbow [10, 13, 14, 30]. Richard et al [14] concluded that direct repair of an acute traumatic avulsion of the MCL utilizing the bone tunnel repair technique in 9 elbows and the suture anchor repair technique in 2 elbows regains valgus stability effectively.…”

Section: Discussionmentioning

confidence: 99%

Severe traumatic valgus instability of the elbow: pathoanatomy and outcomes of primary operation

Zhang

Wang

et al. 2019

J Orthop Surg Res

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BackgroundThe objective of the study was to depict the pathoanatomy of traumatic valgus instability of the elbow and to report clinical outcomes of primary operation.MethodsThirty-one patients presented with traumatic valgus instability of the elbow without dislocation. Thirty-one patients underwent surgical intervention of radial head fractures (28 open reduction and internal fixation and 3 radial head resection) and anatomical repair of the anterior bundle of medial collateral ligament (AMCL) with suture anchors. Twenty patients with disruption of the flexor-pronator tendon (FPT) and 14 patients with tears of the anterior capsule had primary repair of the FPT and anterior capsule simultaneously. Clinical outcomes were evaluated with the Mayo Elbow Performance Score (MEPS), modified hospital for special surgery assessment scale (HSS), and Disabilities of the Arm, Shoulder, and Hand (DASH) score.ResultsThe median follow-up was 37.3 months (range, 15–53 months). Radial head fractures and complete avulsion of the medial collateral ligament (MCL) from its humeral footprint were confirmed in all patients intraoperatively. Intraoperative findings indicated disruption of the FPT in 20 patients and tears of the anterior capsule in 14 patients. Twenty-nine of 31 patients returned to previous activity and work levels within 6 months after surgery. The MEPS, modified HSS, and DASH score were 94 ± 4, 91 ± 5, and 8 ± 2 at the latest follow-up.ConclusionsRadial head fractures with avulsion of the MCL can lead to severe valgus instability of the elbow. Primary operation to repair these disrupted structures, especially repair of the AMCL, can effectively restore valgus stability.

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Surgical repair of traumatic medial disruption of the elbow in competitive athletes.

Cited by 17 publications

References 6 publications

Return to sport after conservative treatment of elbow dislocation in judoka

Return to sport after conservative treatment of elbow dislocation in judoka

Acute severe valgus instability without elbow dislocation

Severe traumatic valgus instability of the elbow: pathoanatomy and outcomes of primary operation

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