Lake Erie College of Osteopathic Medicine Health/Millcreek Community Hospital, Erie, Pennsylvania, USA.
Cox Sports Medicine and Orthopedic Surgery, Mount Pleasant, Michigan, USA.
Am J Sports Med. 2022 Jul;50(8):2198-2202. doi: 10.1177/03635465221094326. Epub 2022 May 23.
Ulnar collateral ligament (UCL) tears in the throwing elbow are classified according to grade and location using magnetic resonance arthrography (MRA). However, the frequency of each tear type and the association to age, competition level, and radiographic findings in adolescent baseball pitchers are unknown.
The primary purpose of this study was to use MRA to characterize the severity, location, and UCL tear type in adolescent pitchers. The second aim was to describe the relationship between the UCL tear type and age, competition level, and plain radiographic findings.
Cross-sectional study; Level of evidence, 3.
Records of adolescent pitchers with a UCL tear treated by the senior author between 2007 and 2016 were retrospectively reviewed. MRA scans were reviewed and tears were classified according to the Joyner-Andrews classification. Low-grade partial tears are classified as type I, high-grade partial tears as type II, complete full-thickness tears as type III, and tear pathology in >1 region in the UCL as type IV. Each type of tear also has a location designated at the midsubstance, ulna (U), or humerus (H). Patient characteristics, competition level, and associated plain radiographic abnormalities were recorded. Univariate analyses were performed to examine the relationships between tear types and age, competition level, and plain radiographic findings.
A total of 200 adolescent pitchers (mean ± SD age, 17.2 ± 1.5 years) with MRA scans were reviewed. Type II-H (n = 62), type II-U (n = 51), and type III-U (n = 28) were the most common tear types observed. Type II tears comprised 64.5% of adolescent UCL tears, with type II-H being the most common. Plain radiographs were abnormal in 32% of patients, with calcifications (10.5%) and olecranon osteophytes (12.5%) being the most common findings. There were no significant relationships between tear type and age ( = .25), competition level ( = .23), or radiographic abnormalities ( = .75).
Humeral-sided high-grade partial tears were the most common tear type in adolescent pitchers. There was no relationship between UCL tear type and age competition level, and plain radiographic abnormalities.
肘 UCL 撕裂在投掷肘根据磁共振关节造影术（MRA）的等级和位置进行分类。然而，在青少年棒球投手中，每种撕裂类型的频率以及与年龄、竞争水平和影像学发现的关系尚不清楚。
本研究的主要目的是使用 MRA 来描述青少年投手 UCL 撕裂的严重程度、位置和撕裂类型。第二个目的是描述 UCL 撕裂类型与年龄、竞争水平和普通 X 线片发现之间的关系。
横断面研究；证据水平，3 级。
回顾性分析 2007 年至 2016 年间由资深作者治疗的 UCL 撕裂的青少年投手的记录。对 MRA 扫描进行了回顾，并根据 Joyner-Andrews 分类对撕裂进行了分类。低等级部分撕裂归类为 I 型，高等级部分撕裂归类为 II 型，完全全层撕裂归类为 III 型，UCL 内多个部位的撕裂归类为 IV 型。每种类型的撕裂也指定了在 UCL 的中部、尺骨（U）或肱骨（H）的位置。记录患者特征、竞争水平和相关的普通 X 线片异常。进行单变量分析以检查撕裂类型与年龄、竞争水平和普通 X 线片发现之间的关系。
共回顾了 200 名接受 MRA 扫描的青少年投手（平均±标准差年龄为 17.2±1.5 岁）。观察到最常见的撕裂类型为 II-H（n=62）、II-U（n=51）和 III-U（n=28）。II 型撕裂占青少年 UCL 撕裂的 64.5%，其中 II-H 最为常见。32%的患者 X 线片异常，最常见的发现是钙化（10.5%）和鹰嘴骨赘（12.5%）。撕裂类型与年龄（=0.25）、竞争水平（=0.23）或 X 线片异常（=0.75）之间无显著关系。
肱骨侧高级部分撕裂是青少年投手中最常见的撕裂类型。UCL 撕裂类型与年龄、竞争水平和普通 X 线片异常无关。
