Return to play rates after ulnar nerve transposition and decompression surgery: a retrospective analysis
Background: Medial elbow pain is a common complaint in overhead throwing athletes. The throwing motion places repetitive tensile and compressive forces on the elbow resulting in significant stress across the ulnohumeral joint. This stress can result in soft-tissue, ligamentous, and ulnar nerve injur...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-03-01
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| Series: | JSES International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666638320302127 |
| _version_ | 1818573912888311808 |
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| author | Christopher J. Hadley, BS Anant Dixit, MD John Kunkel, DO Alex E. White, BA Michael G. Ciccotti, MD Steven B. Cohen, MD Christopher C. Dodson, MD |
| author_facet | Christopher J. Hadley, BS Anant Dixit, MD John Kunkel, DO Alex E. White, BA Michael G. Ciccotti, MD Steven B. Cohen, MD Christopher C. Dodson, MD |
| author_sort | Christopher J. Hadley, BS |
| collection | DOAJ |
| description | Background: Medial elbow pain is a common complaint in overhead throwing athletes. The throwing motion places repetitive tensile and compressive forces on the elbow resulting in significant stress across the ulnohumeral joint. This stress can result in soft-tissue, ligamentous, and ulnar nerve injury. The purpose of this study was to retrospectively investigate the clinical findings and outcomes, including return to play rates, of patients who underwent ulnar nerve transposition surgery for isolated ulnar neuritis. Methods: Throwing athletes who underwent isolated, primary ulnar nerve transposition surgery over an eight-year period, 2009 to 2017, were identified and included in our analysis. Nonthrowing athletes, those who underwent revision ulnar nerve transposition surgery, and those who underwent concomitant ulnar collateral ligament reconstruction or repair were excluded. Patients were contacted to complete the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score as well as a return to play rate questionnaire. The minimum follow-up was 2 years. Results: Fifteen patients met the inclusion criteria: 13 (86.7%) men and 2 (13.3%) women. The average age at the time of surgery was 19.2 years old (range, 15.6-28.0). Preoperatively, 13 (86.7%) patients played baseball and 2 (13.3%) patients played softball. Two patients (13.3%) underwent a previous ulnar collateral ligament reconstruction. There were no complications. The average final follow-up was 65.26 (range, 24.44-113.29) months with an average Kerlan-Jobe Orthopaedic Clinic Score of 64.51 (range, 28.60-100.00). Thirteen (86.7%) patients were able to return to their preinjury sport, 2 to a higher level of competition, 8 to the same level, and 3 to a lower level. Seven of the 13 (53.8%) patients sustained a postoperative ipsilateral shoulder or elbow injury at an average of 19.57 (range, 7.00-36.00) months postoperatively. All patients reported sustaining the injury as a result of throwing. Conclusion: The results of our study indicate that ulnar nerve transposition surgery in throwing athletes allows athletes to return to throwing with low reoperation rates. However, more than half of the athletes in our analysis sustained a subsequent ipsilateral shoulder or elbow injury. Further investigation regarding outcomes in throwing athletes after ulnar nerve transposition surgery is warranted. |
| first_indexed | 2024-12-15T00:19:16Z |
| format | Article |
| id | doaj.art-05380f43f6ce431b9c1686369fbec980 |
| institution | Directory Open Access Journal |
| issn | 2666-6383 |
| language | English |
| last_indexed | 2024-12-15T00:19:16Z |
| publishDate | 2021-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JSES International |
| spelling | doaj.art-05380f43f6ce431b9c1686369fbec9802022-12-21T22:42:22ZengElsevierJSES International2666-63832021-03-0152296301Return to play rates after ulnar nerve transposition and decompression surgery: a retrospective analysisChristopher J. Hadley, BS0Anant Dixit, MD1John Kunkel, DO2Alex E. White, BA3Michael G. Ciccotti, MD4Steven B. Cohen, MD5Christopher C. Dodson, MD6The Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USADepartment of Orthopedic Surgery, Southern California Permanente Medical Group, Kaiser Permanente, Fontana, CA, USADepartment of Orthopedic Surgery, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USASidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USARothman Orthopaedic Institute at the Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USARothman Orthopaedic Institute at the Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USARothman Orthopaedic Institute at the Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA; Correspondence author: Christopher C. Dodson, MD, Rothman Orthopaedic Institute at the Sidney Kimmel Medical College at Thomas Jefferson University, 925 Chestnut Street, Philadelphia, PA 19107, USA.Background: Medial elbow pain is a common complaint in overhead throwing athletes. The throwing motion places repetitive tensile and compressive forces on the elbow resulting in significant stress across the ulnohumeral joint. This stress can result in soft-tissue, ligamentous, and ulnar nerve injury. The purpose of this study was to retrospectively investigate the clinical findings and outcomes, including return to play rates, of patients who underwent ulnar nerve transposition surgery for isolated ulnar neuritis. Methods: Throwing athletes who underwent isolated, primary ulnar nerve transposition surgery over an eight-year period, 2009 to 2017, were identified and included in our analysis. Nonthrowing athletes, those who underwent revision ulnar nerve transposition surgery, and those who underwent concomitant ulnar collateral ligament reconstruction or repair were excluded. Patients were contacted to complete the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score as well as a return to play rate questionnaire. The minimum follow-up was 2 years. Results: Fifteen patients met the inclusion criteria: 13 (86.7%) men and 2 (13.3%) women. The average age at the time of surgery was 19.2 years old (range, 15.6-28.0). Preoperatively, 13 (86.7%) patients played baseball and 2 (13.3%) patients played softball. Two patients (13.3%) underwent a previous ulnar collateral ligament reconstruction. There were no complications. The average final follow-up was 65.26 (range, 24.44-113.29) months with an average Kerlan-Jobe Orthopaedic Clinic Score of 64.51 (range, 28.60-100.00). Thirteen (86.7%) patients were able to return to their preinjury sport, 2 to a higher level of competition, 8 to the same level, and 3 to a lower level. Seven of the 13 (53.8%) patients sustained a postoperative ipsilateral shoulder or elbow injury at an average of 19.57 (range, 7.00-36.00) months postoperatively. All patients reported sustaining the injury as a result of throwing. Conclusion: The results of our study indicate that ulnar nerve transposition surgery in throwing athletes allows athletes to return to throwing with low reoperation rates. However, more than half of the athletes in our analysis sustained a subsequent ipsilateral shoulder or elbow injury. Further investigation regarding outcomes in throwing athletes after ulnar nerve transposition surgery is warranted.http://www.sciencedirect.com/science/article/pii/S2666638320302127Elbowbaseball/softballreturn to playulnar nerve transpositionulnar nerve decompressionthrowing athlete |
| spellingShingle | Christopher J. Hadley, BS Anant Dixit, MD John Kunkel, DO Alex E. White, BA Michael G. Ciccotti, MD Steven B. Cohen, MD Christopher C. Dodson, MD Return to play rates after ulnar nerve transposition and decompression surgery: a retrospective analysis JSES International Elbow baseball/softball return to play ulnar nerve transposition ulnar nerve decompression throwing athlete |
| title | Return to play rates after ulnar nerve transposition and decompression surgery: a retrospective analysis |
| title_full | Return to play rates after ulnar nerve transposition and decompression surgery: a retrospective analysis |
| title_fullStr | Return to play rates after ulnar nerve transposition and decompression surgery: a retrospective analysis |
| title_full_unstemmed | Return to play rates after ulnar nerve transposition and decompression surgery: a retrospective analysis |
| title_short | Return to play rates after ulnar nerve transposition and decompression surgery: a retrospective analysis |
| title_sort | return to play rates after ulnar nerve transposition and decompression surgery a retrospective analysis |
| topic | Elbow baseball/softball return to play ulnar nerve transposition ulnar nerve decompression throwing athlete |
| url | http://www.sciencedirect.com/science/article/pii/S2666638320302127 |
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