Transcript Injuries to the Shoulder and Elbow in the Young Athlete

Injuries to the Shoulder
and Elbow in the Young
Athlete
John F. Meyers, M.D.
Shoulder Girdle
Ligaments 2-5X Stronger
that Epiphyses
Glenohumeral Joint
Little League Shoulder
Perry-Anterior Restraints
•
•
•
•
Retroversion
Labrum
AIGHL
Subscapularis
Surgical Treatment
86% Returned to Sports
Surgical Treatment
• Remove loose bodies
• Excise Capitellar Lesions
• Curette Base
Posterior Elbow Problems
• Triceps Tendonitis
• Traction Apophysitis
• Nonunion Olecranon Epiphysis
Long Term Effects
Jobe
• Olecranon Spurs
• Loose Bodies
• Stretching of the UCL
Prevention
Pappas
• Curve – Medial
• Fast Ball – Lateral
Albright
• Sidearm – 75% Elbow Pain
• Overhead – 27% Elbow Pain
Torg
• Limit the number of innings
pitched
Gymnastics
Fractures and Dislocations
Valgus Injuries
Singer & Roy
4 of 5 Returned
Jackson
0 of 12 Returned
Thank You
Orthopaedic Research of
Virginia
Elbow Injuries in Athletes
John F. Meyers, M.D.
Anatomy
Trauma
Dislocation
Monteggia
Supracondylar Fracture
Olecranon Fracture
Radial Head Fracture
Throwing Injuries
Ligament Injuries
Osteochondritis Dissecans
Little League Elbow
Nerve Injuries
Overuse Injuries
Tennis Elbow
Elbow Arthroscopy
Nirschl
• Tendonitis
• Muscle Weakness
• Upward Migration of Head
Micheli Glousman
• Subtle Instability
• Traction Injury to Rotator Cuff
Elbow Injuries
Baseball Gymnastics
Little League Studies
• 20% Elbow Pain
• 33% X-Ray Changes
Adolescent Pitchers
• 58% Elbow Pain
• 56% X-Ray Changes
• 4% Loose Bodies
Ligament Injuries
Nerve Injuries
Panner’s Disease
• < age 11
• Entire Capitellum
• Self Limited
O.C.D.
• > age 11
• Localized
• Loose bodies
Simonet & Cofield
82% Recurrence in
Athletes
Anterior Subluxation
Dead Arm Syndrome
Diagnosis
• Apprehension
• Arthroscopy
McGlynn & Caspari
• Hill Sachs Lesion
• Labral Tearing
• Incompetent AIGHL
Arthroscopic Treatment of
Anterior Shoulder
Instability
• Bankart Lesion – Repair
• Incompetent – Graft AIGHL
Posterior Dislocation 4%
Posterior Subluxation
Average Age at Onset
16
Posterior Subluxation
• Voluntary
• Unintentional
• Habitual
Function Instability
Pappas