Valgus extension overload syndrome in adolescent baseball players: clinical characteristics and surgical outcomes

详细信息    查看全文

• 作者：Jin-Young Park ; MD^a ; Hyun-Yul Yoo ; MD^b ; Seok Won Chung ; MD^c ; Seung-Jun Lee ; MD^c ; Na Ra Kim ; MD^c ; Se-Young Ki ; MD^c ; Kyung-Soo Oh ; MD^c ; ^d ; ^{orthopaedics11@gmail.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Level IV ; Case Series ; Treatment Study
• 刊名：Journal of Shoulder and Elbow Surgery
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：25
• 期：12
• 页码：2048-2056
• 全文大小：845 K

文摘

Little is known about the clinical characteristics and surgical outcomes of valgus extension overload syndrome (VEOS) in adolescent athletes. We evaluated posteromedial compartment pathology, including combined lesions, and reported the surgical outcomes in adolescent baseball players.

Methods

We retrospectively reviewed the medical records of 13 male adolescent baseball players (mean age, 15.4 years) who underwent arthroscopic olecranon tip resection (n = 9) or staged operations (arthroscopic olecranon tip resection, followed by medial collateral ligament reconstruction 2 weeks later; n = 4). The shape of the tip fragment was used to classify the olecranon into 2 types: type 1, dot-like fragment (n = 3); type 2, triangular-shape fragment (n = 10). Four outcome measures were analyzed: range of motion, visual analog scale (VAS) pain score, rate of return to play, and Conway scale score.

Results

At a mean follow-up of 3.3 years (range, 2-6 years), the mean VAS pain score decreased from 4.1 preoperatively to 1.1 postoperatively (P < .05). Preoperative mean extension and supination were 4.2° and 70.0°, which improved to 1° (P < .05) and 76.2° (P < .05), respectively. The overall rate of return to play was 85% (11 of 13). On the Conway scale, 8 of 13 patients (62%) were classified as excellent. Patients who underwent isolated arthroscopic surgery reported less pain postoperatively and achieved a higher grade on the Conway scale than patients who underwent staged operations.

Conclusions

Arthroscopic resection of olecranon tip yielded favorable outcomes at a minimum of 2 years of follow-up. Patients with concomitant ulnar collateral ligament insufficiency had less optimal outcomes than those with isolated posteromedial impingement.