Ng Wuey Min, Chan Chee Ken, Takahashi Norimasa, Kawai Nobuaki, Teh Kok Kheng, Saravana R, Sugaya Hiroyuki
NOCERAL, Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Funabashi Orthopaedic Sports Medicine Center, Chiba, Japan.
Singapore Med J. 2017 Feb;58(2):103-106. doi: 10.11622/smedj.2016061. Epub 2016 Mar 15.
Injuries to the medial structures of the elbow due to overhead throwing games are well documented. However, variations of medial epicondyles are not well described, especially in athletes with fused medial epicondyles. In this study, we evaluated variations in the medial epicondyle of baseball players who were aged 15-17 years and had fused epicondyles.
In this cross-sectional observational study, 155 skeletally mature baseball players with unilateral medial elbow pain and 310 elbow radiographs were reviewed by two independent reviewers. The medial epicondyles were categorised into three groups: normal, elongated or separated.
Among the 155 patients, 65 (41.9%) had normal epicondyles, 41 (26.5%) had elongated epicondyles and 49 (31.6%) had separated epicondyles. The medial epicondyle was larger on the dominant arm for 125 (80.6%) patients; the mean surface area on the dominant arm was 222.50 ± 45.77 mm, while that of the non-dominant arm was 189.14 ± 39.56 mm (p < 0.01). Among the three categories of medial epicondyles, separated epicondyles had the largest surface area, followed by elongated and normal epicondyles.
Medial epicondyles in adolescent throwing athletes can be categorised into three different groups according to their shape (normal, elongated and separated). We observed a correlation between the shape and the surface area of the medial epicondyle in adolescent throwing athletes, with separated medial epicondyles having the largest surface area. Further studies and follow-up are needed to determine the prognostic value and clinical significance of these morphological variations.
由于过头投掷运动导致的肘部内侧结构损伤已有充分记载。然而，内侧髁的变异情况描述得并不充分，尤其是在融合内侧髁的运动员中。在本研究中，我们评估了年龄在15 - 17岁且内侧髁融合的棒球运动员内侧髁的变异情况。
在这项横断面观察性研究中，两名独立的评估人员对155名骨骼成熟、单侧肘部内侧疼痛的棒球运动员以及310张肘部X光片进行了评估。内侧髁被分为三组：正常、延长或分离。
在155名患者中，65名（41.9%）内侧髁正常，41名（26.5%）内侧髁延长，49名（31.6%）内侧髁分离。125名（80.6%）患者优势侧手臂的内侧髁更大；优势侧手臂的平均表面积为222.50 ± 45.77平方毫米，而非优势侧手臂为189.14 ± 39.56平方毫米（p < 0.01）。在三种内侧髁类型中，分离的内侧髁表面积最大，其次是延长的和正常的内侧髁。
青少年投掷运动员的内侧髁可根据其形状（正常、延长和分离）分为三种不同类型。我们观察到青少年投掷运动员内侧髁的形状与表面积之间存在相关性，分离的内侧髁表面积最大。需要进一步的研究和随访来确定这些形态学变异的预后价值和临床意义。
