Bowers R L, Lourie G M, Griffith T B
Atlanta Braves Baseball Club, Emory Sports Medicine Center, Emory University School of Medicine, 21 Ortho Lane, Atlanta, GA, 30329, USA.
Atlanta Braves Baseball Club, The Hand and Upper Extremity Center of Georgia, Atlanta, GA, USA.
Curr Rev Musculoskelet Med. 2022 Dec;15(6):513-520. doi: 10.1007/s12178-022-09789-w. Epub 2022 Aug 25.
Posteromedial elbow impingement is a common pathological entity in the throwing athlete. The posteromedial articulation of the elbow is a significant stabilizer to medial elbow forces and valgus stress noted during repetitive throwing. This current review investigates recent literature regarding the relevant anatomy, diagnosis, and treatment of posteromedial impingement in the thrower.
Improvements in advanced imaging have provided accurate and detailed diagnostic capability for the assessment of the throwers' elbow. After failure of conservative measures, arthroscopic treatment of posteromedial elbow impingement with posteromedial osteophyte removal has demonstrated excellent outcomes with a reliable return to play in the competitive thrower. In addition to a thorough history and physical examination, MRI, MR arthrogram, CT, and dynamic ultrasound imaging modalities are useful in the assessment of a presumed diagnosis of posteromedial impingement. Arthroscopic decompression with posteromedial osteophyte removal provides effective clinical results and return to play. The surgeon should be careful to avoid creating medial ulnar collateral instability by means of over-resection of the posteromedial olecranon.
肘后内侧撞击是投掷运动员常见的病理情况。肘部的后内侧关节是重复性投掷过程中内侧肘部力量和外翻应力的重要稳定结构。本综述探讨了关于投掷运动员肘后内侧撞击的相关解剖、诊断和治疗的最新文献。
先进成像技术的进步为评估投掷运动员的肘部提供了准确而详细的诊断能力。保守治疗失败后，通过关节镜切除肘后内侧骨赘治疗肘后内侧撞击已显示出良好的效果，竞技投掷运动员能够可靠地恢复运动。除了详细的病史和体格检查外，MRI、磁共振关节造影、CT和动态超声成像方式在评估疑似肘后内侧撞击诊断中很有用。关节镜下减压并切除肘后内侧骨赘可提供有效的临床结果并能恢复运动。外科医生应小心避免因过度切除肘后内侧鹰嘴而导致尺侧副韧带内侧不稳定。
