Age-Specific Prevalence and Clinical Characteristics of Humeral Medial Epicondyle Apophysitis and Osteochondritis Dissecans: Ultrasonographic Assessment of 4249 Players.
Age-Specific Prevalence and Clinical Characteristics of Humeral Medial Epicondyle Apophysitis and Osteochondritis Dissecans: Ultrasonographic Assessment of 4249 Players.
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DOI：
10.1177/2325967117707703
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发表时间：
2017-05
影响因子：
2.6
通讯作者：
Konno S
中科院分区：
文献类型：
--
作者：
Otoshi K;Kikuchi S;Kato K;Sato R;Igari T;Kaga T;Konno S
内上髁牵引性骨突炎（MEC）和肱骨小头剥脱性骨软骨炎（OCD）是青少年棒球运动员常见的肘部损伤。然而，这些病理的年龄特异性患病率及其对肘关节疼痛的影响仍然未知。调查每种MEC病变和肱骨小头强迫症的年龄特异性患病率，并确定每种情况下肘部疼痛的发生率。描述性流行病学研究。研究参与者包括4249名6至17岁的棒球运动员。采用问卷调查法评估肘关节疼痛史，并采用超声检查法评估肘关节形态学变化。关于MEC病变，碎片（FG）和不规则（IR）病变均在11至12岁时达到各自的最高患病率。14岁以后，IR急剧下降，而FG维持在约10%。肥大性（HT）病变急剧增加，在16岁时达到50%以上，而同一年龄组的IR和FG病变减少。除了7 - 8岁的运动员（> 7%）外，所有年龄段的肱骨小头强迫症的患病率保持不变（约2%）。有MEC损伤的运动员与无MEC损伤的运动员相比，（68.0% vs 39.1%），FG病变的风险显著更高（比值比[OR]，4.04; 95% CI，3.16 - 5.22）与IR（OR，3.22; 95% CI，2.44 - 4.27）和HT病变（OR，2.03; 95% CI，1.75 - 2.36）相比。患有肱骨小头强迫症的运动员也有明显更大的肘关节疼痛史的风险（OR，2.34; 95%CI，1.40 - 4.11）。根据每个球员在青春期前和青春期的情况控制练习量和强度，可能对加速骨骼愈合和减少成年期可预防的肘关节疼痛很重要。
Traction apophysitis of medial epicondyle (MEC) lesions and osteochondritis dissecans (OCD) of the capitellum are common elbow injuries in adolescent baseball players. However, the age-specific prevalence of these pathologies and their influence on elbow pain remain unknown. To investigate the age-specific prevalence of each MEC lesion and capitellar OCD and to identify the incidence of elbow pain in each condition. Descriptive epidemiology study. Study participants consisted of 4249 baseball players aged 6 to 17 years. A questionnaire was used to assess history of elbow pain, and morphological changes of the elbow joint were assessed using ultrasonography. Regarding MEC lesions, fragmented (FG) and irregular (IR) lesions both reached their greatest respective prevalence at 11 to 12 years of age. After 14 years of age, IR decreased sharply, whereas FG was maintained at approximately 10%. Hypertrophic (HT) lesions increased sharply, reaching over 50% at 16 years of age, while there was a decrease in IR and FG lesions in the same age group. The prevalence of capitellar OCD remained the same (approximately 2%) throughout all ages except for in players aged 7 to 8 years (>7%). Players with MEC lesions had significantly greater prevalence of a history of elbow pain compared with those without (68.0% vs 39.1%) and were at a significantly greater risk for FG lesions (odds ratio [OR], 4.04; 95% CI, 3.16-5.22) compared with IR (OR, 3.22; 95% CI, 2.44-4.27) and HT lesions (OR, 2.03; 95% CI, 1.75-2.36). Players with capitellar OCD also had a significantly greater risk of a history of elbow pain (OR, 2.34; 95% CI, 1.40-4.11). Controlling the amount of practice and its intensity according to the condition of each player in the preadolescent and adolescent periods may be important in accelerating bony healing and decreasing preventable elbow pain in adulthood.