Diagnosis and treatment of baseball elbow / 中华骨科杂志

ABSTRACT

Objective To evaluate the methods of early diagnosis and the surgical outcomes of se vere baseball elbow.Methods Six surgically treated cases of base ball elbow were included in this stud y.Two patients were treated with arthrosc opy to remove free loose bodies in elb ow joints and synovectomy.Another t wo patients had the big free loose bodie s removed with both arthroscopy and s urgical interventions through small incisions.The remaining 2underwen t d?bridement,cartilage repair and subchondral bone graft.Careful physical examinations as well as X -r ay,CT,3D -CT and MR were performed an d compared before and after operations.Results All the patients suffered from elbow pain and limitations of elbow extension.Limitations of elbow flexion and forearm supination could be seen in some severe cases.MRI was helpful for detecting early lesions.Compared with plain radiograph,it was more sensitive to conduct tomography or roentgenography at 45degrees flexion of elbow.3D -CT coul d illustrate the conditions of cartilage and free loose bodies vividly.T he patients were followed up with an average range of 8.2months postoperatively.The results were evaluated in 4aspects,which included elbow pain,range of motion,joint snap and image features.Three patients had ex-cellent results,two had good and one fair.Five patients got an average in crease of elbow extension for 10degrees.Two of them were competent f or their original job after operatio ns.One patient had gone back to the baseball fields after one-year rehabilitation.Conclusion Careful physical examination and im aging evalu-ations as MRI,tomography or roentge nography at 45degrees flexion of elb ow were essential for early diagnosis.For the patients suffering from base ball elbow,the best results could be obtained with early diagnosis and proper treatments.The surgical out comes tend to be better in the younger patients with the shorter duration o f the disease and less invasive treatm ents.[