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Elbow Injuries in the Adolescent Thrower

  • Injuries in Overhead Athletes (J Dines and C Camp, section editors)
  • Published:
Current Reviews in Musculoskeletal Medicine Aims and scope Submit manuscript

Abstract

Purpose of Review

With an increasing rate of adolescent elbow injuries, especially in throwing athletes, the purpose of this review is to investigate the current literature regarding the diagnosis, treatment, and non-operative and operative outcomes of medial epicondyle fractures, ulnar collateral ligament repair, osteochondritis dissecans of the elbow, and olecranon stress fractures.

Recent Findings

Acceptable outcomes with both non-operative and operative treatments of medial epicondyle fractures have been reported, with surgical indications continuing to evolve. Unstable osteochondritis dissecans lesions, especially in patients with closed growth plates, require operative fixation, and emerging open and arthroscopic techniques including lesion debridement, marrow stimulation, autograft transfer, and allograft transplantation are described with good outcomes. Ulnar collateral repair has emerged as an exciting treatment option for an avulsion of either end of the ligament in young throwing athletes, with faster rehabilitation times than traditional ulnar collateral ligament reconstruction. Olecranon stress fractures are increasing in prevalence, and when a non-operative treatment course is unsuccessful, athletes have a high return-to-play rate after percutaneous cannulated screw placement.

Summary

With proper indications, non-operative and operative treatment modalities are reported with a high return-to-play and acceptable clinical outcomes for common elbow injuries, including medial epicondyle fractures, ulnar collateral ligament repair, osteochondritis dissecans of the elbow, and olecranon stress fractures, in adolescent throwing athletes. Further research is needed to better define treatment algorithms, surgical indications, and outcomes.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Gottschalk HP, Eisner E, Hosalkar HS. Medial epicondyle fractures in the pediatric population. J Am Acad Orthop Surg. 2012;20(4):223–32. https://doi.org/10.5435/JAAOS-20-04-223.

    Article  PubMed  Google Scholar 

  2. Patel B, Reed M, Patel S. Gender-specific pattern differences of the ossification centers in the pediatric elbow. Pediatr Radiol. 2009;39(3):226–31. https://doi.org/10.1007/s00247-008-1078-4.

    Article  PubMed  Google Scholar 

  3. Gottschalk HP, Bastrom TP, Edmonds EW. Reliability of internal oblique elbow radiographs for measuring displacement of medial epicondyle humerus fractures: a cadaveric study. J Pediatr Orthop. 2013;33(1):26–31. https://doi.org/10.1097/BPO.0b013e318279c673.

    Article  PubMed  Google Scholar 

  4. Fowles JV, Slimane N, Kassab MT. Elbow dislocation with avulsion of the medial humeral epicondyle. J Bone Joint Surg Br. 1990;72(1):102–4.

    Article  CAS  PubMed  Google Scholar 

  5. Josefsson PO, Danielsson LG. Epicondylar elbow fracture in children. 35-year follow-up of 56 unreduced cases. Acta Orthop Scand. 1986;57(4):313–5. https://doi.org/10.3109/17453678608994399.

    Article  CAS  PubMed  Google Scholar 

  6. Louahem DM, Bourelle S, Buscayret F, Mazeau P, Kelly P, Dimeglio A, et al. Displaced medial epicondyle fractures of the humerus: surgical treatment and results. A report of 139 cases. Arch Orthop Trauma Surg. 2010;130(5):649–55. https://doi.org/10.1007/s00402-009-1009-3.

    Article  PubMed  Google Scholar 

  7. Farsetti P, Potenza V, Caterini R, Ippolito E. Long-term results of treatment of fractures of the medial humeral epicondyle in children. J Bone Joint Surg Am. 2001;83-A(9):1299–305.

    Article  CAS  PubMed  Google Scholar 

  8. • Knapik DM, Fausett CL, Gilmore A, Liu RW. Outcomes of nonoperative pediatric medial humeral epicondyle fractures with and without associated elbow dislocation. J Pediatr Orthop. 2017;37(4):e224–e8. https://doi.org/10.1097/BPO.0000000000000890. Recent publication highlighting non-operative outcomes in medial epicondyle fractures with and without associated elbow instability.

    Article  PubMed  Google Scholar 

  9. Lee HH, Shen HC, Chang JH, Lee CH, Wu SS. Operative treatment of displaced medial epicondyle fractures in children and adolescents. J Shoulder Elb Surg. 2005;14(2):178–85. https://doi.org/10.1016/j.jse.2004.07.007.

    Article  Google Scholar 

  10. Pace GI, Hennrikus WL. Fixation of displaced medial epicondyle fractures in adolescents. J Pediatr Orthop. 2017;37(2):e80–e2. https://doi.org/10.1097/BPO.0000000000000743.

    Article  PubMed  Google Scholar 

  11. Stepanovich M, Bastrom TP, Munch J 3rd, Roocroft JH, Edmonds EW, Pennock AT. Does operative fixation affect outcomes of displaced medial epicondyle fractures? J Child Orthop. 2016;10(5):413–9. https://doi.org/10.1007/s11832-016-0757-1.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Edmonds EW, Santago AC 2nd, Saul KR. Functional loss with displacement of medial epicondyle humerus fractures: a computer simulation study. J Pediatr Orthop. 2015;35(7):666–71. https://doi.org/10.1097/BPO.0000000000000371.

    Article  PubMed  Google Scholar 

  13. Lawrence JT, Patel NM, Macknin J, Flynn JM, Cameron D, Wolfgruber HC, et al. Return to competitive sports after medial epicondyle fractures in adolescent athletes: results of operative and nonoperative treatment. Am J Sports Med. 2013;41(5):1152–7. https://doi.org/10.1177/0363546513480797.

    Article  PubMed  Google Scholar 

  14. • Biggers MD, Bert TM, Moisan A, Spence DD, Warner WC Jr, Beaty JH, et al. Fracture of the medial humeral epicondyle in children: a comparison of operative and nonoperative management. J Surg Orthop Adv. 2015;24(3):188–92. Recent publication demonstrating excellent outcomes of medial epicondyle ORIF and describing associated complications.

    Article  PubMed  Google Scholar 

  15. Kulkarni VS, Arora N, Gehlot H, Saxena S, Kulkarni SG, Bajwa S. Symptomatic medial humeral epicondylar fracture non-union- rare presentation of a relatively common injury. Injury. 2017;48(Suppl 2):S50–S3. https://doi.org/10.1016/S0020-1383(17)30494-1.

    Article  PubMed  Google Scholar 

  16. Smith JT, McFeely ED, Bae DS, Waters PM, Micheli LJ, Kocher MS. Operative fixation of medial humeral epicondyle fracture nonunion in children. J Pediatr Orthop. 2010;30(7):644–8. https://doi.org/10.1097/BPO.0b013e3181ed4381.

    Article  PubMed  Google Scholar 

  17. Vuillermin C, Donohue KS, Miller P, Bauer AS, Kramer DE, Yen YM. Incarcerated medial epicondyle fractures with elbow dislocation: risk factors associated with morbidity. J Pediatr Orthop. 2017:1. https://doi.org/10.1097/BPO.0000000000000991.

  18. Reinker KA. CORR insights(R): osteochondritis dissecans lesions in family members: does a positive family history impact phenotypic potency? Clin Orthop Relat Res. 2017;475(6):1581–2. https://doi.org/10.1007/s11999-016-5102-y.

    Article  PubMed  Google Scholar 

  19. Nissen CW. Osteochondritis dissecans of the elbow. Clin Sports Med. 2014;33(2):251–65. https://doi.org/10.1016/j.csm.2013.11.002.

    Article  PubMed  Google Scholar 

  20. Takahara M, Mura N, Sasaki J, Harada M, Ogino T. Classification, treatment, and outcome of osteochondritis dissecans of the humeral capitellum. J Bone Joint Surg Am. 2007;89(6):1205–14. https://doi.org/10.2106/JBJS.F.00622.

    Article  PubMed  Google Scholar 

  21. • Kida Y, Morihara T, Kotoura Y, Hojo T, Tachiiri H, Sukenari T, et al. Prevalence and clinical characteristics of osteochondritis dissecans of the humeral capitellum among adolescent baseball players. Am J Sports Med. 2014;42(8):1963–71. https://doi.org/10.1177/0363546514536843. Describes lack of correlation of OCD development to baseball players’ positions.

    Article  PubMed  Google Scholar 

  22. Kijowski R, De Smet AA. Radiography of the elbow for evaluation of patients with osteochondritis dissecans of the capitellum. Skelet Radiol. 2005;34(5):266–71. https://doi.org/10.1007/s00256-005-0899-6.

    Article  Google Scholar 

  23. Kajiyama S, Muroi S, Sugaya H, Takahashi N, Matsuki K, Kawai N, et al. Osteochondritis dissecans of the humeral capitellum in young athletes: comparison between baseball players and gymnasts. Orthop J Sports Med. 2017;5(3):2325967117692513. https://doi.org/10.1177/2325967117692513.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Brittberg M, Winalski CS. Evaluation of cartilage injuries and repair. J Bone Joint Surg Am. 2003;85-A(Suppl 2):58–69.

    Article  Google Scholar 

  25. Itsubo T, Murakami N, Uemura K, Nakamura K, Hayashi M, Uchiyama S, et al. Magnetic resonance imaging staging to evaluate the stability of capitellar osteochondritis dissecans lesions. Am J Sports Med. 2014;42(8):1972–7. https://doi.org/10.1177/0363546514532604.

    Article  PubMed  Google Scholar 

  26. Mihara K, Tsutsui H, Nishinaka N, Yamaguchi K. Nonoperative treatment for osteochondritis dissecans of the capitellum. Am J Sports Med. 2009;37(2):298–304. https://doi.org/10.1177/0363546508324970.

    Article  PubMed  Google Scholar 

  27. Takahara M, Ogino T, Takagi M, Tsuchida H, Orui H, Nambu T. Natural progression of osteochondritis dissecans of the humeral capitellum: initial observations. Radiology. 2000;216(1):207–12. https://doi.org/10.1148/radiology.216.1.r00jl29207.

    Article  CAS  PubMed  Google Scholar 

  28. Bradley JP, Petrie RS. Osteochondritis dissecans of the humeral capitellum. Diagnosis and treatment. Clin Sports Med. 2001;20(3):565–90. https://doi.org/10.1016/S0278-5919(05)70270-2.

    Article  CAS  PubMed  Google Scholar 

  29. Takahara M, Ogino T, Sasaki I, Kato H, Minami A, Kaneda K. Long term outcome of osteochondritis dissecans of the humeral capitellum. Clin Orthop Relat Res. 1999;363:108–15.

    Article  Google Scholar 

  30. • Camp CL, Dines JS, Degen RM, Sinatro AL, Altchek DW. Arthroscopic microfracture for osteochondritis dissecans lesions of the capitellum. Arthrosc Tech. 2016;5(3):e477–81. https://doi.org/10.1016/j.eats.2016.01.030. Description of unique arthroscopic microfracture technique as a treatment modality in OCD lesions of the capitellum.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Bexkens R, van den Ende KIM, Ogink PT, van Bergen CJA, van den Bekerom MPJ, Eygendaal D. Clinical outcome after arthroscopic debridement and microfracture for osteochondritis dissecans of the capitellum. Am J Sports Med. 2017;363546517704842(10):2312–8. https://doi.org/10.1177/0363546517704842.

    Article  Google Scholar 

  32. Koehler SM, Walsh A, Lovy AJ, Pruzansky JS, Shukla DR, Hausman MR. Outcomes of arthroscopic treatment of osteochondritis dissecans of the capitellum and description of the technique. J Shoulder Elb Surg. 2015;24(10):1607–12. https://doi.org/10.1016/j.jse.2015.06.013.

    Article  Google Scholar 

  33. Smith MV, Bedi A, Chen NC. Surgical treatment for osteochondritis dissecans of the capitellum. Sports Health. 2012;4(5):425–32. https://doi.org/10.1177/1941738112444707.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Miyake J, Masatomi T. Arthroscopic debridement of the humeral capitellum for osteochondritis dissecans: radiographic and clinical outcomes. J Hand Surg Am. 2011;36(8):1333–8. https://doi.org/10.1016/j.jhsa.2011.05.024.

    Article  PubMed  Google Scholar 

  35. Jones KJ, Wiesel BB, Sankar WN, Ganley TJ. Arthroscopic management of osteochondritis dissecans of the capitellum: mid-term results in adolescent athletes. J Pediatr Orthop. 2010;30(1):8–13. https://doi.org/10.1097/BPO.0b013e3181c3be83.

    Article  PubMed  Google Scholar 

  36. Caldwell PE 3rd, Auerbach B, Pearson SE. Arthroscopic treatment of capitellum osteochondritis dissecans with micronized allogeneic cartilage scaffold. Arthrosc Tech. 2017;6(3):e815–e20. https://doi.org/10.1016/j.eats.2017.04.007.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Bexkens R, Ogink PT, Doornberg JN, Kerkhoffs G, Eygendaal D, Oh LS, et al. Donor-site morbidity after osteochondral autologous transplantation for osteochondritis dissecans of the capitellum: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2017;25(7):2237–46. https://doi.org/10.1007/s00167-017-4516-8.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Mirzayan R, Lim MJ. Fresh osteochondral allograft transplantation for osteochondritis dissecans of the capitellum in baseball players. J Shoulder Elb Surg. 2016;25(11):1839–47. https://doi.org/10.1016/j.jse.2016.08.006.

    Article  Google Scholar 

  39. Maruyama M, Harada M, Satake H, Tomohiro U, Takagi M, Takahara M. Bone-peg grafting for osteochondritis dissecans of the humeral capitellum. J Orthop Surg (Hong Kong). 2016;24(1):51–6. https://doi.org/10.1177/230949901602400113.

    Article  CAS  Google Scholar 

  40. • Lyons ML, Werner BC, Gluck JS, Freilich AM, Dacus AR, Diduch DR, et al. Osteochondral autograft plug transfer for treatment of osteochondritis dissecans of the capitellum in adolescent athletes. J Shoulder Elb Surg. 2015;24(7):1098–105. https://doi.org/10.1016/j.jse.2015.03.014. Recent article describing technique and outcomes for osteochondral autograft transfer for large unstable OCD lesions.

    Article  Google Scholar 

  41. Nishinaka N, Tsutsui H, Yamaguchi K, Uehara T, Nagai S, Atsumi T. Costal osteochondral autograft for reconstruction of advanced-stage osteochondritis dissecans of the capitellum. J Shoulder Elb Surg. 2014;23(12):1888–97. https://doi.org/10.1016/j.jse.2014.06.047.

    Article  Google Scholar 

  42. Takeba J, Takahashi T, Hino K, Watanabe S, Imai H, Yamamoto H. Arthroscopic technique for fragment fixation using absorbable pins for osteochondritis dissecans of the humeral capitellum: a report of 4 cases. Knee Surg Sports Traumatol Arthrosc. 2010;18(6):831–5. https://doi.org/10.1007/s00167-009-0945-3.

    Article  PubMed  Google Scholar 

  43. van den Ende KI, McIntosh AL, Adams JE, Steinmann SP. Osteochondritis dissecans of the capitellum: a review of the literature and a distal ulnar portal. Arthroscopy. 2011;27(1):122–8. https://doi.org/10.1016/j.arthro.2010.08.008.

    Article  PubMed  Google Scholar 

  44. O’Driscoll SW, Morrey BF. Arthroscopy of the elbow. Diagnostic and therapeutic benefits and hazards. J Bone Joint Surg Am. 1992;74(1):84–94. https://doi.org/10.2106/00004623-199274010-00010.

    Article  PubMed  Google Scholar 

  45. Hennrikus WP, Miller PE, Micheli LJ, Waters PM, Bae DS. Internal fixation of unstable in situ osteochondritis dissecans lesions of the capitellum. J Pediatr Orthop. 2015;35(5):467–73. https://doi.org/10.1097/BPO.0000000000000308.

    Article  PubMed  Google Scholar 

  46. Inoue G. Bilateral osteochondritis dissecans of the elbow treated by Herbert screw fixation. Br J Sports Med. 1991;25(3):142–4. https://doi.org/10.1136/bjsm.25.3.142.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Nobuta S, Ogawa K, Sato K, Nakagawa T, Hatori M, Itoi E. Clinical outcome of fragment fixation for osteochondritis dissecans of the elbow. Ups J Med Sci. 2008;113(2):201–8. https://doi.org/10.3109/2000-1967-232.

    Article  PubMed  Google Scholar 

  48. Takeba J, Takahashi T, Watanabe S, Imai H, Kikuchi S, Umakoshi K, et al. Short-term clinical results of arthroscopic osteochondral fixation for elbow osteochondritis dissecans in teenaged baseball players. J Shoulder Elb Surg. 2015;24(11):1749–56. https://doi.org/10.1016/j.jse.2015.07.009.

    Article  Google Scholar 

  49. Uchida S, Utsunomiya H, Taketa T, Sakoda S, Hatakeyama A, Nakamura T, et al. Arthroscopic fragment fixation using hydroxyapatite/poly-L-lactate acid thread pins for treating elbow osteochondritis dissecans. Am J Sports Med. 2015;43(5):1057–65. https://doi.org/10.1177/0363546515570871.

    Article  PubMed  Google Scholar 

  50. Stone KR, Pelsis JR, Crues JV 3rd, Walgenbach AW, Turek TJ. Osteochondral grafting for failed knee osteochondritis dissecans repairs. Knee. 2014;21(6):1145–50. https://doi.org/10.1016/j.knee.2014.09.003.

    Article  PubMed  Google Scholar 

  51. Maruyama M, Takahara M, Harada M, Satake H, Takagi M. Outcomes of an open autologous osteochondral plug graft for capitellar osteochondritis dissecans: time to return to sports. Am J Sports Med. 2014;42(9):2122–7. https://doi.org/10.1177/0363546514538759.

    Article  PubMed  Google Scholar 

  52. Iwasaki N, Kato H, Ishikawa J, Masuko T, Funakoshi T, Minami A. Autologous osteochondral mosaicplasty for osteochondritis dissecans of the elbow in teenage athletes: surgical technique. J Bone Joint Surg Am. 2010;92(Suppl 1 Pt 2):208–16. https://doi.org/10.2106/JBJS.J.00214.

    Article  PubMed  Google Scholar 

  53. Oka Y, Ikeda M. Treatment of severe osteochondritis dissecans of the elbow using osteochondral grafts from a rib. J Bone Joint Surg Br. 2001;83(5):738–9. https://doi.org/10.1302/0301-620X.83B5.11767.

    Article  CAS  PubMed  Google Scholar 

  54. Sato K, Nakamura T, Toyama Y, Ikegami H. Costal osteochondral grafts for osteochondritis dissecans of the capitulum humeri. Tech Hand Up Extrem Surg. 2008;12(2):85–91. https://doi.org/10.1097/BTH.0b013e31815b2e05.

    Article  PubMed  Google Scholar 

  55. Vezeridis AM, Bae DS. Evaluation of knee donor and elbow recipient sites for osteochondral autologous transplantation surgery in capitellar osteochondritis dissecans. Am J Sports Med. 2016;44(2):511–20. https://doi.org/10.1177/0363546515620184.

    Article  PubMed  Google Scholar 

  56. Rahusen FT, Brinkman JM, Eygendaal D. Results of arthroscopic debridement for osteochondritis dissecans of the elbow. Br J Sports Med. 2006;40(12):966–9. https://doi.org/10.1136/bjsm.2006.030056.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Ueda Y, Sugaya H, Takahashi N, Matsuki K, Tokai M. Mid to long term outcome after arthroscopic fragment resection for capitellar osteochondritis dissecans in adolescent athlete. Orthopaedic Journal of Sports Medicine. 2017;5(7 suppl6):2325967117S00286. https://doi.org/10.1177/2325967117S00286.

    PubMed Central  Google Scholar 

  58. Bexkens R, van den Ende KIM, Ogink PT, van Bergen CJA, van den Bekerom MPJ, Eygendaal D. Clinical outcome after arthroscopic debridement and microfracture for osteochondritis dissecans of the capitellum. Am J Sports Med. 2017;45(10):2312–8. https://doi.org/10.1177/0363546517704842.

    Article  PubMed  Google Scholar 

  59. Westermann RW, Hancock KJ, Buckwalter JA, Kopp B, Glass N, Wolf BR. Return to Sport After Operative Management of Osteochondritis Dissecans of the Capitellum: A Systematic Review and Meta-analysis. Orthop J Sports Med. 2016;4(6):2325967116654651. https://doi.org/10.1177/2325967116654651

  60. Iwasaki N, Yamane S, Nishida K, Masuko T, Funakoshi T, Kamishima T, et al. Transplantation of tissue-engineered cartilage for the treatment of osteochondritis dissecans in the elbow: outcomes over a four-year follow-up in two patients. J Shoulder Elb Surg. 2010;19(8):e1–6. https://doi.org/10.1016/j.jse.2010.05.016.

    Article  Google Scholar 

  61. Morrey BF, An KN. Articular and ligamentous contributions to the stability of the elbow joint. Am J Sports Med. 1983;11(5):315–9. https://doi.org/10.1177/036354658301100506.

    Article  CAS  PubMed  Google Scholar 

  62. Jobe FW, Stark H, Lombardo SJ. Reconstruction of the ulnar collateral ligament in athletes. J Bone Joint Surg Am. 1986;68(8):1158–63. https://doi.org/10.2106/00004623-198668080-00004.

    Article  CAS  PubMed  Google Scholar 

  63. Conway JE, Jobe FW, Glousman RE, Pink M. Medial instability of the elbow in throwing athletes. Treatment by repair or reconstruction of the ulnar collateral ligament. J Bone Joint Surg Am. 1992;74(1):67–83. https://doi.org/10.2106/00004623-199274010-00009.

    Article  CAS  PubMed  Google Scholar 

  64. Erickson BJ, Chalmers PN, Bush-Joseph CA, Verma NN, Romeo AA. Ulnar collateral ligament reconstruction of the elbow: a systematic review of the literature. Orthop J Sports Med. 2015;3(12):2325967115618914. https://doi.org/10.1177/2325967115618914.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Cain EL Jr, Andrews JR, Dugas JR, Wilk KE, McMichael CS, Walter JC 2nd, et al. Outcome of ulnar collateral ligament reconstruction of the elbow in 1281 athletes: results in 743 athletes with minimum 2-year follow-up. Am J Sports Med. 2010;38(12):2426–34. https://doi.org/10.1177/0363546510378100.

    Article  PubMed  Google Scholar 

  66. Dugas JR. Ulnar collateral ligament repair: an old idea with a new wrinkle. Am J Orthop (Belle Mead NJ). 2016;45(3):124–7.

    Google Scholar 

  67. Savoie FH 3rd, Trenhaile SW, Roberts J, Field LD, Ramsey JR. Primary repair of ulnar collateral ligament injuries of the elbow in young athletes: a case series of injuries to the proximal and distal ends of the ligament. Am J Sports Med. 2008;36(6):1066–72. https://doi.org/10.1177/0363546508315201.

    Article  PubMed  Google Scholar 

  68. • Dugas JR, Walters BL, Beason DP, Fleisig GS, Chronister JE. Biomechanical comparison of ulnar collateral ligament repair with internal bracing versus modified Jobe reconstruction. Am J Sports Med. 2016;44(3):735–41. https://doi.org/10.1177/0363546515620390. Study demonstrating biomechanical superiority of the UCL repair internal brace relative to the modified Jobe reconstruction.

    Article  PubMed  Google Scholar 

  69. Argo D, Trenhaile SW, Savoie FH 3rd, Field LD. Operative treatment of ulnar collateral ligament insufficiency of the elbow in female athletes. Am J Sports Med. 2006;34(3):431–7. https://doi.org/10.1177/0363546505281240.

    Article  PubMed  Google Scholar 

  70. Brucker J, Sahu N, Sandella B. Olecranon stress injury in an adolescent overhand pitcher: a case report and analysis of the literature. Sports Health. 2015;7(4):308–11. https://doi.org/10.1177/1941738114567868.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Fujioka H, Tsunemi K, Takagi Y, Tanaka J. Treatment of stress fracture of the olecranon in throwing athletes with internal fixation through a small incision. Sports Med Arthrosc Rehabil Ther Technol. 2012;4(1):49. https://doi.org/10.1186/1758-2555-4-49.

    Article  PubMed  PubMed Central  Google Scholar 

  72. • Paci JM, Dugas JR, Guy JA, Cain EL Jr, Fleisig GS, Hurst C, et al. Cannulated screw fixation of refractory olecranon stress fractures with and without associated injuries allows a return to baseball. Am J Sports Med. 2013;41(2):306–12. https://doi.org/10.1177/0363546512469089. Recent publication with the largest study group regarding outcomes after cannulated screw fixation for olecranon stress fractures.

    Article  PubMed  Google Scholar 

  73. Rettig AC, Wurth TR, Mieling P. Nonunion of olecranon stress fractures in adolescent baseball pitchers: a case series of 5 athletes. Am J Sports Med. 2006;34(4):653–6. https://doi.org/10.1177/03635465281802.

    PubMed  Google Scholar 

  74. Matsuura T, Kashiwaguchi S, Iwase T, Enishi T, Yasui N. The value of using radiographic criteria for the treatment of persistent symptomatic olecranon physis in adolescent throwing athletes. Am J Sports Med. 2010;38(1):141–5. https://doi.org/10.1177/0363546509342677.

    Article  PubMed  Google Scholar 

  75. • Frank RM, Lenart BA, Cohen MS. Olecranon physeal nonunion in the adolescent athlete: identification of two patterns. J Shoulder Elb Surg. 2017;26(6):1044–51. https://doi.org/10.1016/j.jse.2016.11.036. Identification of two unique patterns of olecranon physeal non-unions in adolescent athletes.

    Article  Google Scholar 

  76. Lowery WD, Jr., Kurzweil PR, Forman SK, Morrison DS. Persistence of the olecranon physis: a cause of “little league elbow”. J Shoulder Elb Surg 1995;4(2):143-147, DOI: https://doi.org/10.1016/S1058-2746(05)80070-9.

  77. Schickendantz MS, Ho CP, Koh J. Stress injury of the proximal ulna in professional baseball players. Am J Sports Med. 2002;30(5):737–41. https://doi.org/10.1177/03635465020300051801.

    Article  PubMed  Google Scholar 

  78. Corradin M, Marengo L, Andreacchio A, Paonessa M, Giacometti V, Samba A, et al. Outcome of isolated olecranon fractures in skeletally immature patients: comparison of open reduction and tension band wiring fixation versus closed reduction and percutaneous screw fixation. Eur J Orthop Surg Traumatol. 2016;26(5):469–76. https://doi.org/10.1007/s00590-016-1774-y.

    Article  PubMed  Google Scholar 

  79. Stephenson DR, Love S, Garcia GG, Mair SD. Recurrence of an olecranon stress fracture in an elite pitcher after percutaneous internal fixation: a case report. Am J Sports Med. 2012;40(1):218–21. https://doi.org/10.1177/0363546511422796.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Peachtree Orthopedics, Atlanta, GA, USA

    Timothy B. Griffith, James Kercher & Xavier A. Duralde

  2. Children’s Hospital of Atlanta, Atlanta, GA, USA

    S. Clifton Willimon & Crystal Perkins

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Correspondence to Timothy B. Griffith.

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This article is part of the Topical Collection on Injuries in Overhead Athletes

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Griffith, T.B., Kercher, J., Clifton Willimon, S. et al. Elbow Injuries in the Adolescent Thrower. Curr Rev Musculoskelet Med 11, 35–47 (2018). https://doi.org/10.1007/s12178-018-9457-4

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