Can You Pitch Again if You Hurt Your Ulnar Nerve
Perspective from Anthony A. Romeo, MD
October twenty, 2019
3 min read
Ulnar nerve transposition yielded depression reoperation rates in throwing athletes
Perspective from Anthony A. Romeo, MD
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Steven B. Cohen
NEW YORK — Throwing athletes who underwent ulnar nervus transposition were able to return to play with low reoperation rates, co-ordinate to results presented at the American Shoulder and Elbow Surgeons Annual Meeting.
Steven B. Cohen, MD, and colleagues collected a questionnaire about return to play and re-injury from 23 throwing athletes who underwent isolated ulnar nerve transposition.
"Clinical outcomes included return to play, any type of ipsilateral elbow or shoulder injury and we looked at the [Kerlan-Jobe Orthopaedic Clinic] KJOC scores postoperatively," Cohen said in his presentation hither.
At an average follow-up of about 5 years, Cohen noted 16 patients completed the KJOC score and render-to-play questionnaire. Patients had an boilerplate KJOC score of 63 postoperatively, according to Cohen. He added 100% of patients returned to throwing.
"Withal, xiii of the 16 returned to formal overhead sports and the average time back was about 6 months," Cohen said.
Of the thirteen patients who returned to their formal overhead sports, Cohen noted ten patients returned at the same level or higher.
"Regarding postoperative injuries to the shoulder and elbow, seven patients reported sustaining injury to the shoulder or elbow," Cohen said. "One sustained [ulnar collateral ligament] UCL injury just did not require surgery. Three patients sustained a concomitant rotator cuff and labrum injury that did not require surgery. 3 patients had isolated labral injuries, 2 of which required surgery for a labral debridement and superior labral repair." – by Casey Tingle
Reference:
Hadley CJ, et al. Paper 23. Presented at: American Shoulder and Elbow Surgeons Annual Meeting; Oct. 17-19, 2019; New York.
Disclosure: Cohen reports he is a board or commission member for the American Orthopaedic Society for Sports Medicine and International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine; receives inquiry support from Arthrex Inc. and Major League Baseball; is a paid consultant for ConMed Linvatec and Zimmer; receives publishing royalties, financial or material back up from SLACK Incorporated; and receives IP royalties from and is a paid presenter or speaker for Zimmer.
Perspective
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Anthony A. Romeo, Doc
Steven B. Cohen, MD, and colleagues retrospectively reviewed their patient records for individuals who were baseball players that had an ulnar nerve transposition. In their hands, that procedure is performed in baseball players using a subcutaneous transposition. The nerve is released and so moved anterior to the medial epicondyle underneath the peel, just not underneath the muscle. It'due south a relatively limited amount of trauma to the elbow with the intention that the athletes would be able to return back to their sport with very little limitations or get dorsum to the same level.
They followed their athletes and what they constitute, remarkably, is that ane out of three had difficulty returning back to the same level of throwing. They were surprised at this, but at that place were no specific high-adventure complications or bug, which suggests from their newspaper that, while the ulnar nervus may be the sentinel findings on these athletes in terms of their elbow bothering them, there may exist something else that's going on that's causing a part of the reason that one out of three baseball players with this surgery were not able to go back to aforementioned level. This is remarkably like to a recent newspaper that was published by Brandon J. Erickson, MD, and colleagues that was a review of the wellness information database from Major League Baseball game. In the published series, which is multiple pitchers from multiple teams, information technology was almost the aforementioned consequence that one out of three, despite not appearing to accept another problem, just ulnar nerve symptoms, were not able to render back to the same level of performance.
The conclusion is that the operation is prophylactic, it works very well, it reduces the discomfort related to the ulnar nerve symptoms and two out of 3 will render back to the same level of performance. However, surgeons should be enlightened that there may be other pathologies in the aforementioned elbow in some of the athletes that brand it difficult returning back to the same level, fifty-fifty if they go back to throwing.
Cohen and his colleagues should exist congratulated on an splendid paper. It tells u.s.a. that the operation works well in their easily and it tells us that we just need to be aware that we should look for other problems, such as a problem with ulnar collateral ligament or Tommy John ligament or a trouble with their flexor pronator mass or possibly with their pitching mechanics, as a correspondent to some of the athletes non getting dorsum to the same level of performance afterward this functioning.
Reference:
Erickson BJ, et al. AM J Sports Medicine. 2019;doi:10.1177/0363546519829159.
Anthony A. Romeo, Medico
Primary of orthopedics
Rothman Orthopedics – New York
Professor in the of orthopedic surgery
Hofstra School of Medicine
Northwell Health
Disclosures: Romeo reports he is a paid consultant, designer and developer of products for Arthrex Corporation.
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Can You Pitch Again if You Hurt Your Ulnar Nerve
Source: https://www.healio.com/news/orthopedics/20191021/ulnar-nerve-transposition-yielded-low-reoperation-rates-in-throwing-athletes
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