伦敦大学学院非职业棒球运动员投掷损伤：一项14年的回顾性研究。
UCL Throwing Injuries in Nonprofessional Baseball Players: A 14-Year Retrospective Study.
作者信息
Zaremski Jason L, Pazik Marissa, Hunt Harold, Dodd William S, Nguyen Binh K, Farmer Kevin W, Horodyski MaryBeth
机构信息
Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville, Florida.
Department of Orthopaedic Surgery and Sports Medicine, University of Florida, Gainesville, Florida.
出版信息
Sports Health. 2025 May-Jun;17(3):445-450. doi: 10.1177/19417381241238966. Epub 2024 Mar 29.
BACKGROUND
This study evaluated treatment modality (surgical vs nonoperative) of medial ulnar collateral ligament (UCL) injuries in nonprofessional throwing baseball athletes by comparing type, severity, and location of UCL injury.
HYPOTHESIS
Baseball players with closed medial epicondyle physes and concomitant throwing-related UCL injury will be more likely to undergo surgical intervention than players with open medial epicondyle physes.
STUDY DESIGN
Retrospective.
LEVEL OF EVIDENCE
Level 5.
METHODS
A total of 119 baseball players with a mean age of 16.9 ± 2.5 years (range, 11-25 years) were included in the study. Datapoints included sex, age at time of injury, severity, and location of UCL injury, growth plate status, operative versus conservative management, and concomitant flexor forearm injury.
RESULTS
A total of 75 players were treated conservatively; 43 underwent UCL reconstruction (UCL-R), and 1 had an unknown treatment outcome. No significant difference was found for age related to treatment type, UCL-R (17.2 ± 2.2) versus conservative treatment (16.8 ± 2.6). Athletes with closed medial epicondylar growth plates were more likely to undergo UCL-R than athletes with open medial epicondylar growth plates ( = 0.02). There were no significant differences between UCL injury location (42 distal, 37 proximal, 18 combined tear locations, 11 complete tears, and 11 intact UCLs with inflammation) by treatment type ( = 0.09). There was a significant difference for UCL severity (11 complete tears, 96 partial tears) by treatment type ( = 0.03).
CONCLUSION
Nonprofessional athletes with closed medial epicondylar growth plates and throwing-related UCL injuries were more likely to be treated surgically. Baseball athletes with partial tears, if skeletally immature, require further long-term evaluation.
CLINICAL RELEVANCE
Continued knowledge gains in this area of throwing medicine will further improve our treatment algorithms in nonprofessional baseball players.
背景
本研究通过比较尺侧副韧带（UCL）损伤的类型、严重程度和位置，评估非职业棒球投掷运动员内侧尺侧副韧带损伤的治疗方式（手术治疗与非手术治疗）。
假设
与内侧上髁骨骺开放的运动员相比，内侧上髁骨骺闭合且伴有与投掷相关的尺侧副韧带损伤的棒球运动员更有可能接受手术干预。
研究设计
回顾性研究。
证据水平
5级。
方法
本研究共纳入119名平均年龄为16.9±2.5岁（范围11 - 25岁）的棒球运动员。数据点包括性别、受伤时年龄、尺侧副韧带损伤的严重程度和位置、生长板状态、手术与保守治疗以及前臂屈肌伴随损伤情况。
结果
共有75名运动员接受保守治疗；43名接受了尺侧副韧带重建术（UCL - R），1名治疗结果未知。在与治疗类型相关的年龄方面未发现显著差异，接受UCL - R治疗的患者年龄为17.2±2.2岁，保守治疗的患者年龄为16.8±2.6岁。与内侧上髁骨骺开放的运动员相比，内侧上髁骨骺闭合的运动员更有可能接受UCL - R治疗（P = 0.02）。按治疗类型划分，尺侧副韧带损伤位置（42例远端损伤、37例近端损伤、18例联合撕裂位置、11例完全撕裂以及11例完整但伴有炎症的尺侧副韧带）之间无显著差异（P = 0.09）。按治疗类型划分，尺侧副韧带严重程度（11例完全撕裂、96例部分撕裂）存在显著差异（P = 0.03）。
结论
内侧上髁骨骺闭合且伴有与投掷相关的尺侧副韧带损伤的非职业运动员更有可能接受手术治疗。对于部分撕裂的棒球运动员，如果骨骼未成熟，则需要进一步的长期评估。
临床意义
在投掷医学这一领域不断积累知识将进一步改善我们对非职业棒球运动员的治疗方案。
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