Citation

Sakata J, Miyazaki T, Akeda M, Yamazaki T. J. Shoulder Elbow Surg. 2020; ePub(ePub): ePub.

Copyright

(Copyright © 2020, American Shoulder and Elbow Surgeons, Publisher Elsevier Publishing)

DOI

10.1016/j.jse.2020.09.022

PMID

33069902

Abstract

BACKGROUND: Ulnar collateral ligament (UCL) injuries are common in baseball pitchers. The purpose of this paper is to evaluate changes to the medial elbow joint laxity, under valgus stress, and under valgus stress with flexor digitorum superficialis (FDS) contraction and its ability to predict rehabilitation outcome.

METHODS: Sixty-one UCL injuries were diagnosed. All patients were high school students who initially received rehabilitation treatment. Rates of return to play and return to the same level of play or higher (RTSP) were calculated and correlated with the joint gapping under elbow gravity valgus stress and intra-articular ring-down artifact at rest, under elbow gravity valgus stress, and under elbow gravity valgus stress with maximum FDS contraction.

RESULTS: The overall RTSP rate in patients receiving nonoperative treatment was 83.6% (51/61). RDA at rest significantly differed between the RTSP and non-RTSP groups, with an odds ratio of 17.5. This result indicated that RDA could be a predictor of rehabilitation outcomes. Moreover, there were significant differences in RDA under gravity valgus stress conditions with FDS contraction between the two groups, with an odds ratio of 98.0. Multivariate logistic regression analysis identified 1 variable (ring-down artifact under valgus stress with FDS contraction) as the most significant predictive factor for successful treatment of UCL elbow injury.

CONCLUSIONS: UCL injuries in high school baseball players can be successfully treated nonoperatively in most cases. Stress US with FDS muscle contraction can help predict the potential of RTSP.

Language: en

Keywords

Return to play; Dynamic stabilizer; Elbow; Flexor digitorum superficialis; High school baseball player; Laxity; Rehabilitation outcome; Sonography; Ulnar collateral ligament injuries; Valgus