Injuries to the Shoulder and Elbow in the Young Athlete.

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Presentation transcript:

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 Retroversion Labrum AIGHL Subscapularis

Surgical Treatment 86% Returned to Sports

Surgical Treatment Remove loose bodies Excise Capitellar Lesions Curette Base Remove loose bodies Excise Capitellar Lesions Curette Base

Posterior Elbow Problems

Triceps Tendonitis Traction Apophysitis Nonunion Olecranon Epiphysis Triceps Tendonitis Traction Apophysitis Nonunion Olecranon Epiphysis

Long Term Effects Jobe

Olecranon Spurs Loose Bodies Stretching of the UCL Olecranon Spurs Loose Bodies Stretching of the UCL

Prevention

Pappas Curve – Medial Fast Ball – Lateral Curve – Medial Fast Ball – Lateral

Albright Sidearm – 75% Elbow Pain Overhead – 27% Elbow Pain 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 Tendonitis Muscle Weakness Upward Migration of Head

Micheli Glousman Subtle Instability Traction Injury to Rotator Cuff Subtle Instability Traction Injury to Rotator Cuff

Elbow Injuries

Baseball Gymnastics

Little League Studies 20% Elbow Pain 33% X-Ray Changes 20% Elbow Pain 33% X-Ray Changes

Adolescent Pitchers 58% Elbow Pain 56% X-Ray Changes 4% Loose Bodies 58% Elbow Pain 56% X-Ray Changes 4% Loose Bodies

Ligament Injuries

Nerve Injuries

Panner’s Disease < age 11 Entire Capitellum Self Limited < age 11 Entire Capitellum Self Limited

O.C.D. > age 11 Localized Loose bodies > age 11 Localized Loose bodies

Simonet & Cofield

82% Recurrence in Athletes

Anterior Subluxation

Dead Arm Syndrome

Diagnosis Apprehension Arthroscopy Apprehension Arthroscopy

McGlynn & Caspari Hill Sachs Lesion Labral Tearing Incompetent AIGHL Hill Sachs Lesion Labral Tearing Incompetent AIGHL

Arthroscopic Treatment of Anterior Shoulder Instability

Bankart Lesion – Repair Incompetent – Graft AIGHL Bankart Lesion – Repair Incompetent – Graft AIGHL

Posterior Dislocation 4%

Posterior Subluxation Average Age at Onset 16

Posterior Subluxation Voluntary Unintentional Habitual Voluntary Unintentional Habitual

Function Instability Pappas