Rady Children's Hospital, San Diego, CA.
J Pediatr Orthop. 2024 Sep 1;44(8):e722-e726. doi: 10.1097/BPO.0000000000002731. Epub 2024 May 28.
The long-term prognosis of baseball and softball players diagnosed with Little League elbow (LLE) and Little League shoulder (LLS) is unknown. Many of these athletes are potentially at risk of developing future shoulder and elbow injuries that may require surgical intervention. This study's purpose is to retrospectively assess 5-year patient-reported outcomes and career progression of a series of youth baseball and softball players diagnosed with LLE and LLS.
This institutional review board-approved, single-center, retrospective study evaluated 5-year outcomes of a cohort of youth baseball and softball players diagnosed with LLE and LLS between 2013 and 2017. Demographic and clinical data was recorded including age, gender, primary position, and months played per year. A standardized phone survey was obtained approximately 5 years post-treatment to assess upper extremity function, career progression, and pain recurrence.
Sixty-one patients (44 LLE, 17 LLS) met the inclusion criteria and participated in a standardized phone survey. The mean age at the time of diagnosis was 13.2 years and all but one of the athletes were male. On average, about 80% (34/44 LLE, 15/17 LLS) played baseball 9 months or more per year. After diagnosis and nonoperative management, more than 80% (37/44 LLE, 14/17 LLS) were able to return to competition, but up to 40% of players changed positions (9/44 LLE, 7/17 LLS). Five years later, less than half (21/44 LLE, 8/17 LLS) were playing baseball actively. The recurrence rate was >20% (9/42 LLE, 6/17 LLS) with a mean time of recurrence of 8.8 months. Patients who experienced symptom recurrence were less likely to play baseball 5 years later and had lower patient-reported outcomes.
A diagnosis of LLE and LLS in early adolescence can be a setback for a young athlete. Fortunately, most athletes will be able to return to competition with ∼50% still competing at 5 years. Very few will progress to future arm surgery, but recurrence rates are relatively high, and these athletes are less likely to participate in their sport 5 years later.
Level IV-Retrospective cohort study.
棒球和垒球运动员被诊断为少年棒球肘（Little League elbow，LLE）和少年垒球肩（Little League shoulder，LLS）的长期预后情况未知。这些运动员中许多人都有发生未来肩肘损伤的风险，可能需要手术干预。本研究旨在回顾性评估一系列被诊断为 LLE 和 LLS 的青少年棒球和垒球运动员的 5 年患者报告结局和职业进展情况。
这项机构审查委员会批准的、单中心、回顾性研究评估了 2013 年至 2017 年间被诊断为 LLE 和 LLS 的青少年棒球和垒球运动员的 5 年结局。记录了人口统计学和临床数据，包括年龄、性别、主要位置和每年打球的月数。大约在治疗后 5 年进行标准化电话调查，以评估上肢功能、职业进展和疼痛复发情况。
61 名患者（44 例 LLE，17 例 LLS）符合纳入标准并参加了标准化电话调查。诊断时的平均年龄为 13.2 岁，所有运动员均为男性，除 1 例外。平均而言，约 80%（44 例 LLE 中的 34 例，17 例 LLS 中的 15 例）每年打棒球 9 个月或以上。经过非手术治疗和诊断后，超过 80%（44 例 LLE 中的 37 例，17 例 LLS 中的 14 例）能够重返比赛，但多达 40%的运动员改变了位置（44 例 LLE 中的 9 例，17 例 LLS 中的 7 例）。5 年后，只有不到一半（44 例 LLE 中的 21 例，17 例 LLS 中的 8 例）仍在积极打棒球。复发率＞20%（42 例 LLE 中的 9 例，17 例 LLS 中的 6 例），平均复发时间为 8.8 个月。有症状复发的患者 5 年后更不可能打棒球，且患者报告结局更低。
青少年早期被诊断为 LLE 和 LLS 可能会给年轻运动员带来挫折。幸运的是，大多数运动员在 5 年后能够重返比赛，其中约 50%仍在参加比赛。极少数人会发展为未来的手臂手术，但复发率相对较高，这些运动员在 5 年后更不可能参加他们的运动。
IV 级——回顾性队列研究。
