Elbow problems in the adolescent athlete

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Elbow problems in young adolescent athletes are not common, but since serious sequelae may arise from delayed recognition and treatment, it is important to review the injuries that occur and consider their management. Fortunately the overall incidence of injury to these adolescent athletes is relatively low; 548 of 5,088 patients (11%) examined in the athletic injury section of The Cleveland Clinic Foundation from 1972 to 1974 were age 15 or younger. Seventy-three of these adolescent patients (14%) had sustained injuries to the upper extremities, and in 10 (2%) these injuries involved the elbow. The mechanism of injury fell into one of two categories, being either contact related or the result of the repetitive act of throwing.

Contact injuries

The contact-related injuries frequently encountered are contusions, sprains, and fractures. Contusions result from a direct blow to the involved structures. Contusions to the elbow structures are generally not serious and usually respond to rest and ice; gradual resumption of activities is permitted as tolerated. One exception is the development of traumatic olecranon bursitis, which should be treated by aspiration followed by application of a compression dressing for several days. Repeat aspirations may be necessary, but vigorous attempts to prevent the development of chronic olecranon bursitis are warranted to avoid surgical excision.

Sprains of the capsular and ligamentous structures about the elbow most commonly involve a hyperextension and valgus mechanism placing stress on the anterior and medial structures. These are associated with pain and lack of full elbow motion, with associated tenderness of. . .



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