Avulsion fracture of the sublime tubercle of the ulna: a newly recognized injury in the throwing athlete.

Glajchen, Neville; Schwartz, Martin L.; Andrews, James R.; Gladstone, James N.

doi:10.2214/ajr.170.3.9490942

Cited by 42 publications

(16 citation statements)

References 5 publications

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“…Avulsion of the distal UCL insertion at the sublime tubercle of the ulna has been reported in the acute UCL injury, but some athletes demonstrate ectopic calcification without a history of acute injury. 11 Asymptomatic athletes have also been reported to have ectopic calcification present along the medial elbow. 7 Ectopic UCL calcification may represent either a physiologic response to repetitive trauma or evidence of a previous acute avulsion injury.…”

Section: Discussionmentioning

confidence: 99%

Outcome of Ulnar Collateral Ligament Reconstruction of the Elbow in 1281 Athletes

et al. 2010

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Section: Discussionmentioning

confidence: 99%

Outcome of Ulnar Collateral Ligament Reconstruction of the Elbow in 1281 Athletes

et al. 2010

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“…The anatomic area of injury to this ligament has been documented and most frequently presents as a midsubstance tear. Glajchen et al 4 first described avulsion fracture of the sublime tubercle, a small protuberance on the medial aspect of the coronoid process of the ulna that serves as the distal attachment of the anterior band of the UCL, in a series of 3 throwing athletes with symptomatic medial elbow pain. Conway et al 3 reported the results of 70 patients who had undergone either repair or reconstruction of the UCL.…”

Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Imaging of the Throwing Elbow in the Uninjured, High School–Aged Baseball Pitcher

et al. 2011

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Background Tissue adaptations in response to pitching are an expected finding during magnetic resonance imaging (MRI) evaluation of the throwing elbow of adult pitchers. These changes are considered normal in the absence of symptom complaints. It is unclear when during the playing career these tissue adaptations are initiated. Hypothesis Abnormalities in the appearance of the throwing elbow compared with the nonthrowing elbow would be visible during MRI assessment of this asymptomatic population of high school–aged throwers. Study Design Cross-sectional study; Level of evidence, 3. Methods Twenty-three uninjured, asymptomatic male high school–aged baseball pitchers (mean age, 16 years) with no history of elbow injury were recruited for the study. Participants had a minimum of 3 years’ experience with pitching as their primary position (mean experience, 6 years). Bilateral elbow MRI examinations were performed using a standardized protocol including fast spin-echo proton-density (axial and coronal), T1-weighted (sagittal), and T2-weighted fat-saturated (axial, sagittal, and coronal) sequences. Osteoarticular, ligamentous, musculotendinous, and neural structures were evaluated and compared bilaterally. The images were reviewed by a musculoskeletal radiologist who was blinded to all the gathered data on these athletes, including limb dominance. Results Three participants (13%) had no abnormalities. Fifteen individuals (65%) had asymmetrical anterior band ulnar collateral ligament thickening, including 4 individuals who also had mild sublime tubercle/anteromedial facet edema. Fourteen participants (61%) had posteromedial subchondral sclerosis of the ulnotrochlear articulation, including 8 (35%) with a posteromedial ulnotrochlear osteophyte, and 4 (17%) with mild posteromedial ulnotrochlear chondromalacia. Ten individuals (43%) had multiple abnormal findings in the throwing elbow. Conclusion Thickening of the anterior band of the ulnar collateral ligament and posteromedial subchondral sclerosis of the trochlea are common findings in the high school–aged pitcher and may be considered normal clinical findings in the absence of symptom complaints. Other changes in tissue appearance of the throwing elbow are uncommon in this age group and should be regarded with a higher level of caution when evaluating for the presence of injury. An understanding of the MRI appearance of the uninjured youth pitcher is necessary for clinicians to distinguish between normal adaptations and the presence of injury.

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“…Avulsion fracture of the sublime tubercle is a rare cause of valgus instability of the elbow joint [1,2]. Patients may give a history of overhead throwing activities or symptoms of instability.…”

Section: Discussionmentioning

confidence: 99%

Avulsion Fracture of the Sublime Tubercle: A Case Report

2006

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Fractures of the ulnar sublime tubercle are a rarely reported site of ulnar collateral ligament injury. Presented here is a case report of a displaced avulsion fracture of the sublime tubercle of the ulnar coronoid process in a 58-year-old lady. An open reduction and internal fixation of the fractured sublime tubercle, with two 3 mm cannulated screws, through the medial approach was carried out. Post-operative recovery was complicated by ulnar nerve paraesthesia, which resolved completely. Functional recovery was satisfactory with a return to her normal activities. Traumatic avulsion fracture of the sublime tubercle of the ulnar coronoid process is an underreported injury. Avulsion fracture of the sublime tubercle of the ulnar coronoid process is a rare cause for medial elbow pain and instability. Clinicians should have a high index of suspicion in patients presenting with elbow pain after minimal trauma.

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Avulsion fracture of the sublime tubercle of the ulna: a newly recognized injury in the throwing athlete.

Cited by 42 publications

References 5 publications

Outcome of Ulnar Collateral Ligament Reconstruction of the Elbow in 1281 Athletes

Outcome of Ulnar Collateral Ligament Reconstruction of the Elbow in 1281 Athletes

Magnetic Resonance Imaging of the Throwing Elbow in the Uninjured, High School–Aged Baseball Pitcher

Avulsion Fracture of the Sublime Tubercle: A Case Report

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