S Blake Dowdle1, Peter N Chalmers2. 1. Department of Orthopaedics, University of Utah School of Medicine, 590 Wakara Way, Salt Lake City, UT, 84108, USA. blakedowdle1@gmail.com. 2. Department of Orthopaedics, University of Utah School of Medicine, 590 Wakara Way, Salt Lake City, UT, 84108, USA.
Abstract
PURPOSE OF REVIEW: During overhead throwing, there are tremendous forces placed on the medial elbow that can result in injury to the ulnar nerve. The purpose of this article is to review the anatomy, biomechanics, and appropriate clinical care of an overhead throwing athlete suffering from injury to their ulnar nerve. The authors preferred clinical work-up; non-operative and operative care are included in this review. RECENT FINDINGS: More recent findings support the use of subcutaneous transposition instead of the submuscular transpositions and only to perform a transposition in the setting of specific pre-operative findings. Subcutaneous transpositions have led to decreased rates of post-operative symptoms and complications. Understanding the complexity of the medial elbow is essential to making an accurate diagnosis of ulnar neuritis/neuropathy in the overhead throwing athlete. In general, non-operative management has shown to be successful; however, in those refractory or recurrent cases of ulnar neuritis, ulnar nerve decompression with or without transposition provides these athletes with a surgical procedure that has shown to provide patients with excellent outcomes. Continued refinement surgical indications and surgical technique will allow for a high percentage of athletes who return to competitive sports following surgery for ulnar neuropathy.
PURPOSE OF REVIEW: During overhead throwing, there are tremendous forces placed on the medial elbow that can result in injury to the ulnar nerve. The purpose of this article is to review the anatomy, biomechanics, and appropriate clinical care of an overhead throwing athlete suffering from injury to their ulnar nerve. The authors preferred clinical work-up; non-operative and operative care are included in this review. RECENT FINDINGS: More recent findings support the use of subcutaneous transposition instead of the submuscular transpositions and only to perform a transposition in the setting of specific pre-operative findings. Subcutaneous transpositions have led to decreased rates of post-operative symptoms and complications. Understanding the complexity of the medial elbow is essential to making an accurate diagnosis of ulnar neuritis/neuropathy in the overhead throwing athlete. In general, non-operative management has shown to be successful; however, in those refractory or recurrent cases of ulnar neuritis, ulnar nerve decompression with or without transposition provides these athletes with a surgical procedure that has shown to provide patients with excellent outcomes. Continued refinement surgical indications and surgical technique will allow for a high percentage of athletes who return to competitive sports following surgery for ulnar neuropathy.
Authors: Christopher J Hadley; Anant Dixit; John Kunkel; Alex E White; Michael G Ciccotti; Steven B Cohen; Christopher C Dodson Journal: JSES Int Date: 2021-02-09
Authors: Somnath Rao; Taylor D'Amore; Donald P Willier; Richard Gawel; Robert A Jack; Steven B Cohen; Michael G Ciccotti Journal: Orthop J Sports Med Date: 2021-11-23