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Download Injuries to the Shoulder and Elbow in the Young Athlete
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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
