Abstract
Background
The incidence of throwing-related elbow injuries is still rising. The study aimed
to enhance the pathology of acute medial elbow injuries among young Little Leaguers
by examining the medial elbows of symptomatic 9–10 years old Little Leaguers using
High-Definition Magnetic Resonance Images (HDMRI), which uses a small-diameter surface
coil on the target area, leading to greater image resolution.
Method
We identified Little Leaguers aged 9–10 years old. To minimize the detection of the
chronic adaptative changes, players who experienced the medial elbow pain previously
and whose HDMRI had not been taken within 4 weeks from the onset of medial elbow pain
were excluded. This study considered 21 players, and the mean age was 9.4 ± 0.5 years.
Result
The fragmentation of the medial epicondyle apophysis via HDMRI was found in 15 elbows
(71.4%), while the avulsion was seen in three cases. The signal hyperintensity at
the medial epicondyle apophysis was observed in 2 cases. Our data showed abnormal
changes to the medial epicondyle apophysis and surrounding structures, such as the
ulnar collateral ligament (UCL), flexor-pronator tendons or the coronoid process of
the ulna. We detected 11 abnormalities on X-ray imaging, while 20 subjects showed
some abnormal findings via HDMRI.
Discussion
The current study showed that initial medial elbow injury in Little Leaguers without
a history of previous elbow injury could be attributed to multi-structure injury.
Over 90% of subjects were injured in the perichondrium, while 71.4% demonstrated a
fragmentation of the secondary ossification center, and 14.3% experienced an avulsion
of the medial epicondyle apophysis. Because the injuries were not limited to bony
structures, HDMRI may be beneficial for the appropriate evaluation of medial elbow
pain. The pathology of initial medial elbow injuries in young baseball players may
be due to acute trauma instead of repetitive microtrauma.
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Article info
Publication history
Published online: January 05, 2022
Accepted:
December 14,
2021
Received in revised form:
December 9,
2021
Received:
July 15,
2021
Identification
Copyright
© 2021 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.
