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PubMed2002

Traumatic elbow injuries in the athlete.

Traumatic injuries to the elbow are not uncommon in the athlete. A fall onto the out-stretched arm may result in fracture of the radial head, dislocation of the elbow, or other injuries about the joint. Strength training and contact sports may cause rupture of the biceps or triceps tendon at the elbow. It is important for the sports medicine physician to become familiar with injury patterns about the elbow in athletes and treatment options. This article will be devoted to a summary of classification, diagnosis, and treatment considerations for selected traumatic athletic injuries of the elbow.

Athletic Injuries↗
PubMedDate not supplied

Elbow injury in women's gymnastics.

This investigation reports on 30 female gymnasts with 32 elbow injuries acquired in gymnastics. Thirty of the injuries were acute fractures and dislocations, and two developed Panner's disease of the humeral capitellum. Primary treatment included 14 closed reductions and 11 open surgical procedures. Those who returned to competition lost an average of 4.1 months. Spotters were not present during nearly 60% of these injuries. The mechanism which led to a variety of elbow injuries was possibility singular: a fall on an outstretched arm. More than twice as many injuries occurred on this mats or the bare floor than on thicker mats. The authors concluded, after the study, that elbow immobilization for as short a time as possible was beneficial to regaining range of motion. We recommend reducing injuries by employing spotters, using thicker mats, and educating young gymnasts in techniques of falling.

Adolescent↗
PubMed1996

Fractures of the radial head and associated elbow injuries in children.

Fractures of the radial head are frequently associated with elbow injuries in children. Thirty-seven patients with this association treated at the Nancy Children's Hospital were analyzed to ascertain the mechanism and the unfavorable factors of prognosis. The mechanism responsible was a valgus strain on the elbow at the moment of impact, associated with forces of compression and distraction. At an average follow-up of 2 years, 76% excellent and good results were obtained. Conservative treatment was always effective in minimally displaced fractures. With surgical reduction by closed intramedullary pinning (CIMP), there were only three failures in severely displaced fractures. With open reduction, results were always poor; 88% patients with fair and poor results had an associated fracture of the olecranon. The unfavorable prognostic factors were the severity of the initial tilting and displacement, the presence of associated elbow injuries, the inadequacy of reduction, and the open reduction procedure.

Adolescent↗
PubMed1953

Elbow injuries.

Explore the source record for details and available documents.

Arm Injuries↗
PubMed2001

Elbow injuries in golf.

Golf is not a sport known for its high injury level; however, injuries do occur. Such mishaps usually involve overuse-type injuries that are more common among amateur golfers than among professional golfers. This article attempts to provide an overview of golf injuries to the elbow, with a concentration on incidence, proper diagnosis, adequate treatment (including rehabilitation), and prevention strategies. After reading this article, primary care physicians should be able to manage most golfing injuries to the elbow.

Arthrography↗
PubMed1995

Elbow injuries.

Injuries about the elbow are common in racquet sports. Lateral epicondylitis is seen most often, but symptoms can arise from other sources including the medial elbow and the articular surfaces themselves. Medial elbow symptoms can result from medial epicondylitis, medial collateral ligament injury, ulnar nerve trauma, or any combination of these injuries. Careful evaluation of medial elbow pain is required to define the causes. Proper technique, conditioning, and equipment are also important in reducing the risk of injury to the elbow.

Biomechanical Phenomena↗
PubMed2006

Using sonography for the early detection of elbow injuries among young baseball players.

OBJECTIVE: The aim of this study was to determine the usefulness of sonography for detecting elbow injuries among young baseball players. SUBJECTS AND METHODS: One hundred fifty-three volunteers ranging in age from 9 to 12 years and belonging to youth baseball teams participated. Sonography of the elbow was performed in the field when baseball exercises were being conducted. We analyzed the relationship between elbow pain and sonographic abnormalities and the relationship between pitchers and sonographic abnormalities. RESULTS: Sonography showed that 33 subjects had medial epicondylar fragmentation and two had early-stage osteochondritis dissecans of the capitellum. In 25 subjects who agreed to further examination and treatment, radiography confirmed the sonographic findings. All of the 23 subjects with medial epicondylar fragmentation, who stopped throwing, obtained union of the bone and returned to baseball. The two subjects with osteochondritis dissecans of the capitellum underwent surgery before the osteochondral fragment became loosened. Sonographic abnormalities correlated with episodes of elbow pain. Pitchers statistically significantly had sonographic abnormalities. CONCLUSION: Sonography in the field can provide an opportunity to detect and treat elbow injuries before they become more advanced.

Age Factors↗
PubMed2004

Unilateral hinged external fixator of the elbow in complex elbow injuries.

We present the outcome of treating complex injuries of the elbow with the "Orthofix" external fixator in patients where the condition of the soft tissues did not permit extensile surgical approach or where the internal fixation would not be stable enough to permit safe early joint mobilization postoperatively. Eight patients were treated, three with supra-intercondylar fracture in the presence of marked osteoporosis and five with fracture-dislocation of the elbow and excessive soft tissue impairment. The fixator was applied for a mean of 8.5 weeks (5-13 weeks). Great care was taken to use the appropriate technique in applying the fixator, especially to define the correct centre of rotation. All the fractures were united, and no instability of the joint was noted. All the patients maintained a functional range of motion, with lack of extension less than 30 degrees and flexion more than 120 degrees . One patient who developed transient palsy of the radial nerve and two patients who developed pin track infection were treated with oral antibiotics. Despite the technical difficulties, external fixation of the elbow could be a salvage procedure in difficult cases of elbow trauma, where open procedures are not indicated.

Adult↗
PubMed2000

Evaluation of overuse elbow injuries.

The evaluation of elbow pain can be challenging because of the complexity of the joint and its central location in the upper extremity. Diagnosing the injury correctly requires an understanding of the anatomy of the elbow, which includes three articulations, two ligament complexes, four muscle groups and three major nerves. The history should be directed at pinpointing the location of symptoms and the activities that cause the patient's pain. It is important to identify the specific musculotendinous structures that are at risk for overuse or have been injured through overuse. Mechanical symptoms are indicative of intra-articular pathology, whereas neurologic symptoms are characteristic of nerve entrapment syndromes. Physical examination of the elbow and related structures should confirm the diagnosis. Only a minority of patients require diagnostic studies. Basic treatment principles are described by the acronym PRICEMM: protection, rest, ice, compression, elevation, medication and modalities (physical therapy). Surgical consultation is warranted in selected patients.

Cumulative Trauma Disorders↗
PubMedDate not supplied

Evaluation of the role of comparison radiographs in the diagnosis of traumatic elbow injuries.

This study attempted to determine whether comparison radiographic views of the uninjured elbow result in increased diagnostic accuracy. Physicians (one junior and one senior orthopaedic resident and an orthopaedic surgeon) were provided with a short clinical summary and asked to interpret radiographs of the injured elbow (IE) or both the injured and uninjured elbow (UE) in a randomized fashion from 25 children with elbow injuries. The overall percentage of correct diagnoses (one vs. two elbow radiographs) were as follows: orthopaedic surgeon, 80 versus 96%; for junior resident, 80 versus 84%; and for senior resident, 84 versus 88% (p > 0.05). Kappa scores for interobserver variability and intrarater agreement were in the high range (0.756 to 0.904, kappa = 0.08). Clinically relevant diagnoses were missed by trainees (not the orthopaedic surgeon) whether radiographs of IE or both IE and UE were interpreted. Incorrect radiograph interpretations were due to false positives in 39 of 40 cases. Comparison radiographs of the UE were not useful in improving diagnostic accuracy in elbow trauma. However, although they may be necessary in some instances, routine radiographic examination of the UE is not warranted.

Adolescent↗
PubMed1999

Elbow injuries in the throwing athlete. Difficult diagnoses and surgical complications.

Elbow injuries in throwing athletes can be challenging from the diagnostic and management perspectives. The stress of repetitive throwing does predispose athletes to certain conditions with which treating clinicians need to be familiar. An understanding of the anatomy of the elbow and the biomechanics of throwing is essential to making the correct diagnosis and instituting proper care. Failure of nonoperative measures often requires surgical intervention. A thorough understanding of the anatomy and the spectrum of conditions that can occur is needed before decisions regarding surgical management can be made. The operative approach to elbow pathology, whether performed open or arthroscopically, should be completed by orthopedists who have experience with the clinical conditions and the appropriate technical facility to provide comprehensive care. This article has reviewed the anatomy, biomechanics, and spectrum of conditions that affect throwing athletes' elbows as well as the potential complications that can be associated with surgical management.

Arthroscopy↗
PubMed2000

Management of the floating elbow injury in children. Simultaneous ipsilateral fractures of the elbow and forearm.

Simultaneous ipsilateral fracture of the elbow and forearm--floating elbow--is an uncommon injury. During a 7-year period we prospectively followed 12 children who presented with completely displaced supracondylar fractures of the humerus associated with a forearm fracture of the same limb. All patients underwent emergency operative reduction and percutaneous K-wire stabilisation. At a minimum of 18 months, all patients were assessed clinically and radiologically and the results evaluated according to a conventional scoring system. Ten patients had good or excellent outcomes, and there were two fair results. The incidence of open fractures and nerve injury and the need to perform an open reduction were higher than those recorded for isolated supracondylar fractures. The floating elbow is an indicator of a high energy injury and requires aggressive operative management.

Age Factors↗
PubMed1998

Common elbow injuries in sport.

Athletes of all ages and skill levels are increasingly participating in sports involving overhead arm motions, making elbow injuries more common. Among these injuries is lateral epicondylitis, which occurs in over 50% of athletes using overhead arm motions. Lateral epicondylitis is characterised by pain in the area where the common extensor muscles meet the lateral humeral epicondyle. The onset of this pathological condition begins with the excessive use of the wrist extensor musculature. Repetitive microtraumatic injury can lead to mucinoid degeneration of the extensor origin and subsequent failure of the tendon. Lateral epicondylitis can almost always be treated nonoperatively with activity modification and specific exercises. If the athlete fails to respond to nonoperative treatment after 6 months to 1 year, they are candidates for surgical intervention. Medial epicondylitis is characterised by pain and tenderness at the flexor-pronator tendinous origin with pathology commonly being located at the interface between the pronator teres and flexor carpi radialis origin. Golfers and tennis players often develop this condition because of the repetitive valgus stress placed on the medial elbow soft tissues. Careful evaluation is important to differentiate medial epicondylitis from other causes of medial elbow pain. As with lateral epicondylitis, patients with medial epicondylitis not responding to an extensive nonoperative programme are candidates for surgical intervention. A less common cause of medial elbow pain is medial ulnar collateral ligament injury. Repetitive valgus stress placed on the joint can lead to microtraumatic injury and valgus instability. When the medial ulnar collateral ligament is disrupted, abnormal stress is placed on the articular surfaces that can lead to degenerative changes with osteophyte formation. As with other elbow injuries, a strict rehabilitation regimen is first employed; ligament reconstruction is only recommended if the injury fails to improve and only in athletes requiring a high level of performance. Excessive valgus stress can also lead to posteromedial olecranon impingement on the olecranon fossa producing pain, osteophyte and loose body formation. Arthroscopic elbow debridement can often be helpful in improving motion and in reducing pain in such patients.

Athletic Injuries↗
PubMedDate not supplied

Shoulder and elbow injuries in the skeletally immature athlete.

The intensity of training and competition among young athletes can place them at increased risk of acute and chronic injuries, which occur in patterns unique to the skeletally immature athlete. Prompt recognition and treatment of these injuries are critical to prevent long-term functional disability and deformity. Children and adolescents participating in recreational and organized sports are particularly susceptible to a broad spectrum of shoulder and elbow injuries involving both osseous and soft-tissue structures. Understanding the relevant functional anatomy, biomechanics of throwing, and pathophysiology of injury can help the clinician manage common acute traumatic injuries, some of which may result in chronic problems. Over-use injuries occur more frequently than do acute, traumatic injuries, and early recognition, coupled with appropriate treatment or prevention, can help restore and maintain normal shoulder and elbow function.

Adolescent↗
PubMedDate not supplied

Ulna neuropathy after elbow injury in children.

Six children developed seven cases of ulna neuropathy between 7 days and 6 years after significant elbow injury. None had evidence of acute nerve damage at the time of initial trauma. This complication, which develops soon after injury, has not been well documented. For this reason, the mode of presentation, treatment options, and review of the literature is presented.

Adolescent↗
PubMedDate not supplied

Arthrographic diagnosis of elbow injuries in children.

A prospective study was established to evaluate the value of arthrography in children with a variety of elbow injuries. Thirty-six arthrograms were performed on children with an average age of 3.8 years at an average of 20 h from the time of injury. The diagnosis made on the basis of standard radiographs was confirmed for 17 patients, and the initial diagnosis was altered for seven (19%). More important was that the treatment of these seven patients was altered by the arthrographic findings. Six of these seven were candidates for surgical management until arthrographic evaluation indicated a different diagnosis or that they could be treated nonoperatively. Elbow arthrography is recommended in skeletally immature patients whose diagnosis is in doubt. This technique is particularly helpful in humeral condylar fractures.

Arthrography↗