Itoh Y, Wakano K, Takeda T, Murakami T
Am J Sports Med. 1987 May-Jun;15(3):264-9. doi: 10.1177/036354658701500315.
Three cases of circulatory disturbance with ulcer formation in the pitching hand of baseball pitchers are reported. The pathophysiology was of an entirely new entity. In one case, the neurovascular bundles of the middle finger were entrapped by the proximal edges of Cleland's ligaments. In the other two cases, the blood vessels to the index and middle fingers were compressed within the lumbrical canal. Hypertrophy of the lumbrical muscles and/or thickening of the palmar aponeurosis were responsible for the compression of the vessels. Surgical release of Cleland's ligaments or palmar aponeurosis, including superficial transverse fiber and vertical septa, resulted in good recovery of the circulation of the involved fingers. All of the pitchers returned to professional or college league baseball without recurrence of the ulcer.
报告了3例棒球投手投球手出现循环障碍并伴有溃疡形成的病例。其病理生理学是一种全新的情况。在1例病例中，中指的神经血管束被克莱兰韧带的近端边缘卡压。在另外2例病例中，示指和中指的血管在蚓状肌管内受到压迫。蚓状肌肥大和/或掌腱膜增厚是血管受压的原因。对克莱兰韧带或掌腱膜（包括浅横纤维和垂直间隔）进行手术松解，使受累手指的循环得到良好恢复。所有投手均重返职业或大学联盟棒球比赛，溃疡未复发。
