Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, 310 East 71st Street, Apt 3H, New York, NY 10021, USA.
Curr Opin Pediatr. 2010 Feb;22(1):35-40. doi: 10.1097/MOP.0b013e328334584c.
The present review aims to provide a synopsis of the current literature on little league shoulder, including etiology, diagnosis, prevention, and treatment.
As management involving little league shoulder has not drastically changed over recent years, most current research evaluating youth throwing athletes with shoulder pain relates to biomechanics and prevention. Current literature on biomechanics indicates that the maximum shoulder external rotation and ball release phases of throwing provide the highest rotational torque and distraction forces, respectively, with the maximum external rotation phase being most likely related to the development of little league shoulder. In addition, targets for prevention have also been identified in youth throwing athletes, including current or prior history of shoulder pain, variability in mechanics, glenohumeral internal rotation deficit, and accordance with throwing guidelines, especially in at-risk baseball pitchers.
Little league shoulder is most commonly seen in youth throwing athletes between 11 and 16 years of age. Clinical evaluation and radiographic imaging typically confirms the diagnosis. Management is most effectively performed through prevention. With the onset of little league shoulder, nonoperative treatment is typically successful, with a 3-month period of rest followed by a progressive throwing program with subsequent return to play.
本综述旨在概述目前有关儿童棒球肩的文献，包括病因、诊断、预防和治疗。
由于近年来涉及儿童棒球肩的管理并未发生重大变化，因此目前评估有肩部疼痛的青少年投掷运动员的大多数研究都与生物力学和预防有关。目前有关生物力学的文献表明，投掷过程中的最大肩部外旋和球释放阶段分别提供了最高的旋转扭矩和分离力，最大外旋阶段最可能与儿童棒球肩的发展有关。此外，在青少年投掷运动员中也确定了预防目标，包括当前或既往肩部疼痛史、力学变化、盂肱关节内旋不足以及符合投掷指南，尤其是在有风险的棒球投手中。
儿童棒球肩最常见于 11 至 16 岁的青少年投掷运动员。临床评估和影像学检查通常可确诊。通过预防，最有效地进行管理。出现儿童棒球肩后，非手术治疗通常是有效的，可先休息 3 个月，然后进行逐步的投掷训练，随后恢复运动。
