The Hip: Preservation, Replacement and Revision

Injuries of the Throwing Elbow

- See: throwing injuries and throwing injuries of the shoulder

- Discussion: - phases of throwing:
          - windup
          - early cocking
          - late cocking
                - wrist begins to cock in preparation for the throw and final energy release.
                - begins when the pitcher's front foot touches the ground and terminates with maximal humeral external rotation;
                - elbow remains flexed between 60 deg to 75 deg
                - ECRB and ECRL show relatively high levels of activity;
                - significant valgus force at elbow occurs at this stage (maximal MCL stress);
                - dynamic stabilizers include: FDS and FCU;
          - acceleration
                - starts with maximal humeral external rotation and ends with ball release;
                - elbow experiences a rapid combination of valgus and extension;
                - significant valgus force at elbow occurs at this stage but not as much as the late cocking phase
                - maximal activity in pronator teres, FCR and FCU;
                - extended wrist flexes at this stage;
                - dynamic stabilizers include: FDS and FCU;
                - ref: Functional anatomy of the flexor pronator muscle group in relation to the medial collateral ligament of the elbow.
          - deceleration - shows the largest amount of muscle activity by the elbow flexors
          - follow through
          - other considerations:
                 - extension overload
                 - triceps muscle strain
                 - avulsion fracture tip of olecranon
                 - olecranon hypertrophy
                       - Olecranon stress fractures in throwers. A report of two cases and a review of the literature
                 - loose bodies in the olecranon fossa
                 - tears of brachialis and anterior capsule
                 - fixed flexion contracture;
                 - posterolateral instability
                 - ulnar nerve: (cubital tunnel syndrome)
                       - Ulnar nerve entrapment syndrome in baseball players.  
                       - Traumatic ulnar neuropathy in adolescent baseball pitchers

- Diff Dx Pediatric Throwing Elbow(Radiology of Pediatric Elbow)
 


Throwing injuries of the elbow in athletes.      
Correctable elbow lesions in professional baseball players. A review of 25 cases.  
Throwing injuries of the elbow.   
An electromyographic analysis of the elbow in normal and injured pitchers with medial collateral ligament insufficiency.
An electromyographic analysis of the upper extremity in pitching.  
Medial instability of the elbow in throwing athletes. Treatment by repair or reconstruction of the ulnar collateral ligament.
Nonoperative treatment of ulnar collateral ligament injuries in throwing athletes.




Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Wednesday, May 30, 2012 2:06 pm