JSES International (May 2022)

The influence of chronic medial epicondylar apophysitis on medial ulnar collateral ligament insufficiency—: a retrospective cohort study

  • Kenichi Otoshi, MD, PhD,
  • Shinichi Kikuchi, MD, PhD,
  • Kinshi Kato, MD, PhD,
  • Yota Kaneko, MD,
  • Ryosuke Mashiko, MD,
  • Ryohei Sato, MD, PhD,
  • Takahiro Igari, MD, PhD,
  • Takahiro Kaga, MD, PhD,
  • Shinichi Konno, MD, PhD

Journal volume & issue
Vol. 6, no. 3
pp. 539 – 544

Abstract

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Background: This study aimed to investigate the effect of chronic traction apophysitis of the medial epicondyle (MEC) on medial ulnar collateral ligament (MUCL) insufficiency in high school baseball players. Methods: In this retrospective cohort study, 3034 of 6069 high school baseball players were enrolled. A self-reported questionnaire was distributed to investigate past history of elbow pain and elbow pain during the previous season. Physical examinations to assess tenderness on the MUCL and the elbow valgus stress test (EVST) were performed. Ultrasonography was performed to determine the presence of morphological abnormalities of the anteroinferior aspect of the MEC (MEC lesions). Results: Participants with MEC lesions had a significantly higher prevalence of past history of elbow pain, elbow pain during the previous season, MUCL tenderness, and positive EVST than those without MEC lesions (P < .05). Multivariate logistic regression analysis revealed that the participants with the fragmented type had the highest risk of past history of elbow pain (odds ratio [OR] = 3.94), elbow pain during the previous season (OR = 2.27), positive EVST (OR = 3.49), and the second highest risk of MUCL tenderness (OR = 2.01) followed by the irregular type (OR = 2.31). Participants with the hypertrophic type had the lowest risk of past history of elbow pain (OR = 2.08), elbow pain during the previous season (OR = 1.42), MUCL tenderness (OR = 1.09), and positive EVST (OR = 1.47). Conclusion: The presence of chronic non-healed traction apophysitis of the MEC in high school baseball players presented a significantly high risk of elbow pain and MUCL insufficiency.

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