Valgus Laxity of Elbow Joint in High School Weight Lifters: Ultrasonographic Assessment

Abstract

We evaluated abnormalities in medial portion of elbow in high-school weightlifter compared with the non weightlifter using a stress radiography and ultrsonography. The experimental group(G1) was 26 high school weightlifters with an average age of 17 years old (range, 16-18 years). The control group (G2) were comprised of 25 age matched general students. Both groups received physical examination, simple and valgus stress radiography and ultrasonography on both side of elbow. Physical examination showed 26.9% (14/52 elbows) tenderness and 19.2% (10/52 elbows) valgus laxity in G1, no tenderness and laxity in G2. There were no differences in medial joint gaps on simple radiography (G1, 3.3 mm, G2, 2.7 mm; p＞0.05), but the valgus stress view showed 5.6±0.8 mm medial joint gap in G1 and 3.8±0.8 mm in G2 (p＜0.001). Ultrasonography in G1, angular deformity was found in 67.3% (36/52) and G2 all in normal (p＜0.01). The horizontal distance was an average 4.9±1.23 mm for the G1 and 3.1±0.78 mm for the G2 (p＜0.001). Vertical distance of the proximal portion of the ulna was average 0.58±0.94 mm for the G1 and 1.59±0.49 mm for the G2 (p＜0.001). In G1, angular deformity of male was 50% (15/30 elbows) and female was 95% (21/22 elbows) (p＜0.001). Change of horizontal and vertical distance were larger in female (p＜0.05). In conclusion, there were increased incidence of medial elbow joint laxity in high school weightlifter, especially in female, regardless of career. Sustained valgus laxity could be prone to ulnar collateral ligament injury and should be evaluated with ultrasonography-assisted dynamic study.