scholarly journals What are the Risk Factors for Failure after Conservative Treatment of Ulnar Collateral Ligament Injuries of the Elbow in Baseball Players?

2013 ◽  
Vol 1 (4_suppl) ◽  
pp. 2325967113S0001
Author(s):  
Kozo Furushima ◽  
Yoshiyasu Itoh ◽  
Shohei Iwabu
Keyword(s):  
Risk Factors ◽  
Conservative Treatment ◽  
Ulnar Collateral Ligament ◽  
Ligament Injuries ◽  
Collateral Ligament ◽  
Baseball Players

Increased pitch velocity and workload are common risk factors for ulnar collateral ligament injury in baseball players: a systematic review

2018 ◽  
Vol 4 (1) ◽  
pp. 41-47
Author(s):  
Ryan P Coughlin ◽  
Yung Lee ◽  
Nolan S Horner ◽  
Nicole Simunovic ◽  
Edwin R Cadet ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Injury Prevention ◽  
Ulnar Collateral Ligament ◽  
Quality Data ◽  
Sufficient Evidence ◽  
Collateral Ligament ◽  
Level Of Evidence ◽  
Baseball Players ◽  
The Impact

ImportanceUlnar collateral ligament (UCL) injuries commonly occur in baseball players. Strategies for injury prevention have long been accepted without clinical data informing which risk factors lead to serious injury.ObjectiveThe objective of this study was to systematically review the impact of various pitching-related risk factors for UCL injury in baseball players from all levels of play.Evidence reviewThe electronic databases MEDLINE, EMBASE and PubMed were systematically searched until 4 March 2018, and pertinent data were abstracted by two independent reviewers. Search terms included ‘ulnar collateral ligament’, ‘medial ulnar collateral ligament’, ‘Tommy John’, ‘risk’ and ‘association’. Inclusion criteria were English-language studies, level of evidence I–IV and studies reporting risk factors for UCL injury of the elbow in baseball players. Study quality was assessed using the methodological index for non-randomised studies (MINORS) criteria. The results are presented in a narrative summary.FindingsPitching practices (workload and pitch characteristics) were reported in 9/15 studies. Specifically, three of four studies (n=1810) reported increased pitch workload as a risk factor for native UCL injury (p<0.001 to 0.02). The most common pitch characteristic reported was pitch velocity with four of five studies showing increased velocity being significantly associated with native UCL injury (p<0.01 to 0.02). Biomechanical risk factors reported were increased humeral retrotorsion (two studies; n=324), poor lower extremity and trunk balance (one study; n=42) and loss of total arc of shoulder motion (two studies; n=118), all significantly associated with UCL injury (p<0.0001 to 0.05). One of three studies assessing pitch workload as a risk factor for re-rupture of UCL reconstruction found a significant association (p<0.01).Conclusions and relevancePitching practices, reflected by increased pitch workload and velocity, were most commonly associated with UCL injury; however, the definition of workload (number of pitches per game, inning or season) was inconsistently reported. Biomechanical risk factors were less commonly reported and lack sufficient evidence to recommend preventative strategies. More quality data is needed to refine the current recommendations for injury prevention in baseball players.Level of evidenceIII.

scholarly journals Risk of Fragments in Ulnar Collateral Ligament Injuries Of Baseball Players

2016 ◽  
Vol 4 (7_suppl4) ◽  
pp. 2325967116S0010
Author(s):  
Kozo Furushima ◽  
Yoshiyasu Itoh ◽  
Yasuhiro Mitsui ◽  
Hiroshi Kusano
Keyword(s):  
Ulnar Collateral Ligament ◽  
Ligament Injuries ◽  
Collateral Ligament ◽  
Baseball Players

scholarly journals Epidemiology of Elbow Ulnar Collateral Ligament Injuries Among Baseball Players: Response

2018 ◽  
Vol 47 (1) ◽  
pp. NP11-NP11
Author(s):  
Steven F. DeFroda ◽  
Avi D. Goodman ◽  
Joseph A. Gil ◽  
Brett D. Owens
Keyword(s):  
Ulnar Collateral Ligament ◽  
Ligament Injuries ◽  
Collateral Ligament ◽  
Baseball Players

scholarly journals Return to Play Following Nonoperative Treatment of Partial Ulnar Collateral Ligament Injuries in Professional Baseball Players: A Critically Appraised Topic

2019 ◽  
Vol 28 (6) ◽  
pp. 660-664
Author(s):  
Nicole Cascia ◽  
Tim L. Uhl ◽  
Carolyn M. Hettrich
Keyword(s):  
Conservative Treatment ◽  
Conservative Management ◽  
Ulnar Collateral Ligament ◽  
Nonoperative Treatment ◽  
Return To Play ◽  
Current Evidence ◽  
Professional Baseball ◽  
Inclusion Criteria ◽  
Collateral Ligament ◽  
Baseball Players

Clinical Scenario: Ulnar collateral ligament (UCL) injuries are highly prevalent in professional baseball players with the success of operative management being well known in the literature. Return to play (RTP) rates following nonoperative management of partial UCL injuries in professional baseball players are not well established in the literature. With a UCL tear being a potential career-ending injury, it is imperative that the best treatment option is provided to these throwing athletes. There is an increase in the incidence of UCL surgical rates and a lack of general agreement on nonoperative treatment of partial UCL injuries as reported by the American Shoulder and Elbow Surgeons in 2017. There is also a lack of clarity on when to initiate rehabilitation, which may be due to the limited amount of studies reporting success of RTP rates and time to RTP following conservative interventions of partial UCL injuries. Evidence on the RTP rates seen following conservative management of partial UCL tears injuries can help guide health care providers in deciding on the best treatment option for professional baseball athletes who desire to return to their athletic careers. These rates of RTP will add valuable objective input when determining if conservative management is the best choice. To determine the current evidence, inclusion criteria for the literature search consisted of RTP rates following conservative treatment in professional baseball players between inception and 2018. Clinical Question: Is there evidence for successful RTP rates in professional baseball players following conservative treatment of a UCL injury? Summary of Key Findings: Three retrospective studies met the inclusion criteria and were included. Of those, 2 reported RTP rates following a nonoperative rehabilitation program of a UCL injury, whereas 1 reported RTP rates after injection therapy in subjects who attempted a trial of conservative treatment. All 3 studies considered location and grade of UCL tear. Successful RTP rates (66%–100%) were reported in professional baseball players following nonoperative treatment of partial UCL injuries. Clinical Bottom Line: Current evidence supports high success with RTP rates up to 100% after nonoperative treatment of grade 1 UCL injuries in professional baseball players and between 66% and 94% for a grade 2 and above. Strength of Recommendation: There is level C evidence for high RTP rates following nonoperative treatment of partial UCL injuries in professional baseball players.

Combined Flexor-Pronator Mass and Ulnar Collateral Ligament Injuries in the Elbows of Older Baseball Players

2010 ◽  
Vol 38 (4) ◽  
pp. 733-739 ◽  
Author(s):  
Daryl C. Osbahr ◽  
Swarup S. Swaminathan ◽  
Answorth A. Allen ◽  
Joshua S. Dines ◽  
Struan H. Coleman ◽  
...  
Keyword(s):  
Ulnar Collateral Ligament ◽  
Ligament Injuries ◽  
Collateral Ligament ◽  
Baseball Players

Epidemiology of Elbow Ulnar Collateral Ligament Injuries Among Baseball Players: National Collegiate Athletic Association Injury Surveillance Program, 2009-2010 Through 2013-2014

2018 ◽  
Vol 46 (9) ◽  
pp. 2142-2147 ◽  
Author(s):  
Steven F. DeFroda ◽  
Avi D. Goodman ◽  
Joseph A. Gil ◽  
Brett D. Owens
Keyword(s):  
Risk Factors ◽  
National Collegiate Athletic Association ◽  
Ulnar Collateral Ligament ◽  
Injury Surveillance ◽  
Return To Play ◽  
Surveillance Program ◽  
Characteristic Analysis ◽  
Collateral Ligament ◽  
Baseball Players ◽  
Significant Difference

Background: Injuries to the ulnar collateral ligament (UCL) of the elbow are of major concern in baseball; however, the epidemiology of these injuries among National Collegiate Athletic Association (NCAA) athletes is poorly described. Purpose: To determine the incidence of UCL injuries in NCAA baseball and investigate the risk factors involved. Study Design: Descriptive epidemiology study. Methods: All UCL injuries for academic years 2009-2010 through 2013-2014 were extracted from the NCAA Injury Surveillance Program database. The incidence was calculated for different positions, activity, time in game, competition status, and injury characteristics and compared via injury risk ratios to determine risk factors for injury occurrence. The NCAA provides sampling weights based on division and year. For all other injury characteristic analysis, unweighted data were used. Results: Over the course of the 2009-2010 to 2013-2014, 20 UCL injuries were reported in the NCAA Injury Surveillance Program over 177,992 athletic exposures (AEs) for an overall incidence of 1.12 per 10,000 AEs (95% CI, 0.63-1.62). Eighty-five percent occurred during throwing, and 100% were new injuries. Of the injuries sustained during games, 28.6% occurred early (warm-up through third inning) and 71.4% late (fourth inning or later), with a risk ratio of 1.3 for late-game injuries (95% CI, 0.24-6.44). Of those injured, 45.0% were able to return to play by the next season, while the remainder were out for at least 7 days. Injury was season ending for 15% of athletes (0.17 per 10,000 AEs), and 15% of athletes required surgery. Conclusion: UCL injury is a potentially season-ending, even career-ending, injury among NCAA baseball players. Additionally, while more injuries occurred later in games, the current study revealed no significant difference in injury rates with respect to time in game. Last, the authors found a higher reported rate of extensive time away from sport after UCL injury than previously published studies on this patient population.

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