Shoulder and elbow injuries in the adolescent population can be generally divided into skeletally immature and skeletally mature. Skeletally immature injuries refer to damage to the open growth plate (physis) in the young athlete, which have distinct differences in long-term risks if not managed correctly due to the potential for growth disturbance. Skeletally mature injuries occur in athletes with closed growth plates and are less likely to limit growth potential. It is important to recognize these different types of injuries, as well as the patients most at risk for each type because treatment may vary significantly between the two groups. The main skeletally immature injuries covered by this review will include: medial epicondyle apophysitis ("Little Leaguer's elbow), medial epicondyle fractures, olecranon stress fractures, capitellar osteochondritis dissecans (OCD), and proximal humeral apophysitis ("Little Leaguer's shoulder"). The skeletally mature injuries discussed will include: valgus extension overload syndrome (VEOS), ulnar collateral ligament (UCL) tear, shoulder instability, and superior labral anterior-posterior (SLAP) tears. We will review the history and presentation of the injuries as well as different treatment strategies and return to play guidelines for both primary care sports physicians as well as orthopedic surgeons.
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Children (Basel)
November 2024
Service of Traumatology and Orthopaedics Surgery, Hospital 12 de Octubre, 28041 Madrid, Spain.
Pediatric elbow fractures are quite common, accounting for up to 34% of bone fractures in children. Among these, acute lateral humeral condyle (LHC) fractures represent up to 22%. The accurate diagnosis and early treatment of LHC fractures are crucial due to the potential for abnormal growth and significant long-term impacts on joint motion.
View Article and Find Full Text PDFVet Radiol Ultrasound
January 2025
Royal (Dick) School of Veterinary Studies and Roslin Institute, The University of Edinburgh, Roslin, UK.
Two skeletally immature female dogs were each investigated for chronic weight-bearing thoracic limb lameness. The first patient was lame for 2 months following a tumble whilst playing, and the second patient had been intermittently lame since 3 weeks of age. In both cases, radiographic examination of the shoulder revealed fissuring of the caudal humeral head consistent with an incomplete proximal humeral Salter-Harris type IV fracture with an Enoki-mushroom-like appearance of the caudal fragment, where two heads rise from a common stem.
View Article and Find Full Text PDFAm J Sports Med
January 2025
Department of Orthopaedic Surgery, Hebei Medical University Third Hospital, Shijiazhuang, China.
Background: Studies have revealed abnormalities of the epiphyseal plate of the distal femur in patients with trochlear dysplasia, but it is unclear whether the epiphyseal plate could be remodeled after surgical correction of patellar dislocation.
Purpose: To investigate whether the morphology of the epiphyseal plate and trochlea could be improved after medial patellar retinaculum plasty in skeletally immature patients and to investigate the correlations between the morphology of the epiphyseal plate and trochlear dysplasia as well as clinical outcomes.
Study Design: Cohort study; Level of evidence, 3.
Curr Rev Musculoskelet Med
December 2024
Wake Forest School of Medicine, Department of Orthopaedic Surgery, 1 Medical Center Blvd, Winston Salem, NC, 27103, USA.
Purpose Of Review: Adolescent idiopathic scoliosis (AIS) is a disabling spinal pathology, with a significant morbidity if left untreated. This review investigates the recent advances in the diagnosis and management of AIS.
Recent Findings: Low radiation techniques have become a paramount focus in the management of patient's with AIS.
J Pers Med
November 2024
Center for Diagnostic and Interventional Radiology and Nuclear Medicine, Charité-University Medicine Berlin, 10117 Berlin, Germany.
There remains considerable debate regarding the optimal management of anterior cruciate ligament (ACL) injuries in skeletally immature patients. This study aims to evaluate the clinical outcomes of transphyseal ACL reconstruction in patients with open growth plates. This retrospective study included skeletally immature patients with full-thickness ACL tears and confirmed open physis.
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