小儿上肢运动损伤的新进展有哪些？

What's New in Pediatric Upper Extremity Sports Injuries?

作者信息

Beck Jennifer J, Richmond Connor G, Tompkins Marc A, Heyer Ann, Shea Kevin G, Cruz Aristides I

机构信息

Orthopedic Institute for Children/UCLA, Los Angeles, CA.

St. Luke's Health System, Boise, ID.

出版信息

J Pediatr Orthop. 2018 Feb;38(2):e73-e77. doi: 10.1097/BPO.0000000000001104.

DOI:10.1097/BPO.0000000000001104

PMID:29117014

Abstract

BACKGROUND

Sports injuries are common in pediatric and adolescent patients and the evaluation and treatment of these injuries continues to evolve. The purpose of this review is to provide a comprehensive appraisal of the most recent literature, highlighting updates on sports-related upper extremity injuries in pediatric patients.

METHODS

An electronic search of the PubMed, EMBASE, and Google Scholar databases was performed for keywords related to pediatric overhead athletes, osteochondritis dissecans (OCD) of the capitellum, medial epicondyle fractures, shoulder instability, and clavicle fractures. Search results were filtered by publication date to yield articles published electronically or in print on or after January 1, 2013 to May 30, 2017. Papers were selected based on expert opinion and consensus by the authors and included if deemed to have contributed important findings to the above topics.

RESULTS

A total of 51 articles were deemed to have contributed significant findings to the literature: 11 overhead athlete, 9 OCD of the capitellum, 6 medial epicondyle fractures, 17 shoulder instability, and 8 clavicle fractures. The level of evidence for most studies was either Level III or IV.

CONCLUSIONS

Overuse and traumatic conditions of the pediatric elbow including UCL tear, capitellar OCD, and medial epicondyle fractures represent a significant portion of injuries in the overhead athlete. Research in the prevention and treatment of primary and recurrent shoulder instability in young athletes continues to evolve. The operative treatment of clavicle fractures in adolescents has been increasing without a commensurate increase in the level of evidence supporting such treatment. Advances have been made in the treatment of sports-related upper extremity injuries in pediatric patients, however, high-level, comparative outcomes research in many areas is lacking and this review may help inform topics for future study.

LEVEL OF EVIDENCE

Level IV-Literature review.

摘要

背景

运动损伤在儿童和青少年患者中很常见，对这些损伤的评估和治疗也在不断发展。本综述的目的是对最新文献进行全面评估，重点介绍儿科患者与运动相关的上肢损伤的最新进展。

方法

在PubMed、EMBASE和谷歌学术数据库中进行电子搜索，搜索与儿科过头运动运动员、肱骨小头剥脱性骨软骨炎（OCD）、内上髁骨折、肩关节不稳和锁骨骨折相关的关键词。搜索结果按出版日期进行筛选，以获取2013年1月1日至2017年5月30日以电子或印刷形式发表的文章。根据作者的专家意见和共识选择论文，如果认为对上述主题有重要发现则纳入。

结果

共有51篇文章被认为对该文献有重大贡献：11篇关于过头运动运动员，9篇关于肱骨小头OCD，6篇关于内上髁骨折，17篇关于肩关节不稳，8篇关于锁骨骨折。大多数研究的证据水平为III级或IV级。

结论

儿科肘部的过度使用和创伤性疾病，包括尺侧副韧带撕裂、肱骨小头OCD和内上髁骨折，在过头运动运动员的损伤中占很大比例。年轻运动员原发性和复发性肩关节不稳的预防和治疗研究仍在不断发展。青少年锁骨骨折的手术治疗一直在增加，但支持这种治疗的证据水平并未相应提高。儿科患者与运动相关的上肢损伤的治疗取得了进展，然而，许多领域缺乏高水平的比较性结局研究，本综述可能有助于为未来的研究提供参考。