West Tennessee Bone and Joint Clinic, Jackson, TN, USA.
West Tennessee Bone and Joint Clinic, Jackson, TN, USA.
J Shoulder Elbow Surg. 2017 Dec;26(12):2220-2225. doi: 10.1016/j.jse.2017.08.013. Epub 2017 Sep 28.
Elite-level women's fastpitch softball players place substantial biomechanical strains on the elbow that can result in medial elbow pain and ulnar neuropathic symptoms. There is scant literature reporting the expected outcomes of the treatment of these injuries. This study examined the results of treatment in a series of these patients.
We identified 6 female softball pitchers (4 high school and 2 collegiate) with medial elbow pain and ulnar neuropathic symptoms. Trials of conservative care failed in all 6, and they underwent surgical treatment with subcutaneous ulnar nerve transposition. These patients were subsequently monitored postoperatively to determine outcome.
All 6 female pitchers had early resolution of elbow pain and neuropathic symptoms after surgical treatment. Long-term follow-up demonstrated that 1 patient quit playing softball because of other injuries but no longer reported elbow pain or paresthesias. One player was able to return to pitching at the high school level but had recurrent forearm pain and neuritis 1 year later while playing a different sport and subsequently stopped playing competitive sports. Four patients continued to play at the collegiate level without further symptoms.
Medial elbow pain in women's softball pitchers caused by ulnar neuropathy can be treated effectively with subcutaneous ulnar nerve transposition if nonsurgical options fail. Further study is necessary to examine the role of overuse, proper training techniques, and whether pitching limits may be necessary to avoid these injuries.
精英女子快速垒球运动员对肘部施加大量生物力学压力，这可能导致肘部内侧疼痛和尺神经病变症状。关于这些损伤的治疗效果，相关文献报道较少。本研究对一系列此类患者的治疗结果进行了研究。
我们共确定了 6 名患有肘部内侧疼痛和尺神经病变症状的女子垒球投手（4 名高中生和 2 名大学生）。所有 6 名患者均经保守治疗失败，随后接受了皮下尺神经转位手术治疗。这些患者术后接受了随访，以确定治疗效果。
所有 6 名女子垒球投手在接受手术治疗后肘部疼痛和神经病变症状均迅速缓解。长期随访显示，1 名患者因其他伤病而停止打垒球，但不再报告肘部疼痛或感觉异常。1 名患者虽能重返高中垒球比赛，但在参加另一项运动 1 年后再次出现前臂疼痛和神经炎，随后停止了竞技运动。4 名患者继续以大学生身份参加比赛，未再出现症状。
如果非手术治疗失败，女性垒球投手因尺神经病变引起的肘部内侧疼痛可通过皮下尺神经转位得到有效治疗。需要进一步研究过度使用、适当的训练技术以及是否需要设定投球限制以避免这些损伤。
