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Update on the Treatment of Adolescent Elbow Injuries
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Posted on: 07/26/2007
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Elbow injuries are on the rise. This has been linked with the fact that 4.5 million children between the ages of five and fourteen are playing baseball and softball. It's estimated that up to half of these children will have overuse or traumatic elbow injuries.
In this review, Dr. Tashjian from the University of Utah gives an update on the latest treatment for these two types of elbow disorders. Prevention of elbow injuries is also described.
Athletes involved in overhead sports such as baseball are at risk for elbow injuries. Gymnasts are also at increased risk due to repetitive loading on the elbow joint. Repetitive trauma may reduce the blood supply to the cartilage cells. Normally, these cells will eventually turn into bone. The process is called ossification. Without a good blood supply, ossification is disrupted.
The most common conditions described in this article include osteochondritis dissecans (OCD), injury to the ulnar collateral ligament, and elbow fractures. Treatment varies depending on the athlete's age, activity level, and severity of the problem.
OCD is a condition in which fragments of cartilage or bone have become loose inside the elbow joint. Pain and inflammation occur and reduce elbow motion and function. For athletes with OCD, changing the activities and decreasing the activity level are advised.
If these conservative measures don't work, then surgery may be needed. The loose pieces are either removed or reattached. Children who have surgery for large fragments have the worst results. Healing is delayed when there isn't enough healthy cartilage to protect the area. Return to sports is unlikely when open surgery is done to remove large, unstable fragments.
Surgery to repair a torn ligament is usually able to get the athlete back to their sport in an average of three months. Elbow fractures and dislocations can be treated with or without surgery. The decision about which type of treatment is best can be difficult to make. The goal is to stabilize the elbow without causing nerve damage or a deformity.
And finally, elbow injury prevention is an ongoing topic of discussion. The authors report the USA Baseball Medical and Safety Advisory Committee have made some recommendations for young pitchers. Parents and coaches must monitor athletes for signs of fatigue. Athletes should not play when they are in pain. And the number of pitches per game, per month, and per season should be carefully watched.
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References:
Robert Z. Tashjian, M.D. Adolescent Elbow Injuries. In Current Opinion in Orthopaedics. July 2007. Vol. 18. No. 4. Pp. 403-410.
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*Disclaimer:*The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. |
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