Anatomic, Functional, and Mechanical Risk Factors for Elbow Injury in the Throwing Athlete: A Prospective Cohort Study of 128 High School Baseball Players

Ryosuke Nishi, Takahisa Ogawa, Yuki Obokata, Kozo Furushima, Kunio Kamatani
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Abstract

Background: Among high school baseball players, elbow injury is a significant career-threatening problem. Although structural abnormalities of the elbow joint, poor physical function, and faulty pitching mechanics have been identified as potential risk factors for this disorder, their relationship has not been fully elucidated. Purpose: To determine the interaction among these risk factors and, in particular, to examine whether structural abnormalities of the elbow joint are an important risk factor for elbow injury. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 128 new members of a high school baseball team were evaluated for structural abnormalities of the elbow joint using ultrasound, physical function tests, and an analysis of pitching motion. Follow-ups were then conducted for 6 months to monitor the occurrence of elbow injury. Logistic regression analysis was performed to analyze the data. Results: Twenty-three participants (18%) developed elbow injury within 6 months. Multivariate logistic regression analysis revealed that irregularity of the medial epicondyle, hypertrophy of the medial epicondyle, and increased external rotation of the shoulder were significantly associated with elbow injury within 6 months, with odds ratios of 5.42 ( P < .001), 3.17 ( P = .03), and 1.04 ( P = .01), respectively. Conclusion: Irregularity and hypertrophy of the medial epicondyle and increased external rotation range of motion of the shoulder joint were identified as risk factors for elbow injury. Further research is needed to determine whether early identification of these factors and appropriate countermeasures can reduce the incidence of elbow injury.
投掷运动员肘部损伤的解剖、功能和机械危险因素:128名高中棒球运动员的前瞻性队列研究
背景:在高中棒球运动员中,肘部损伤是一个重要的职业威胁问题。虽然肘关节结构异常、身体功能差和俯仰力学缺陷已被确定为该疾病的潜在危险因素,但它们之间的关系尚未完全阐明。目的:确定这些危险因素之间的相互作用,特别是检查肘关节结构异常是否是肘关节损伤的重要危险因素。研究设计:队列研究;证据等级2。方法:对128名高中棒球队新成员进行肘关节结构异常的超声检查、身体功能检查和投球运动分析。随访6个月,观察肘部损伤的发生情况。采用Logistic回归分析对数据进行分析。结果:23名参与者(18%)在6个月内发生肘部损伤。多因素logistic回归分析显示,6个月内肘关节损伤与内上髁不规则、内上髁肥大、肩关节外旋量增加相关,优势比为5.42 (P <;.001)、3.17 (P = .03)、1.04 (P = .01)。结论:内上髁不规则、肥大、肩关节外旋活动范围增大是肘关节损伤的危险因素。早期识别这些因素并采取适当的对策是否能够降低肘关节损伤的发生率,还需要进一步的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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