Valgus extension overload: diagnosis and treatment

Area of Science:

• Orthopedics
• Sports Medicine
• Biomechanics

Background:

• Valgus extension overload (VEO) and olecranon stress fractures are common elbow pathologies in overhead athletes.
• These conditions result from high, repetitive stresses during overhead throwing motions.
• VEO is characterized by pain when the elbow is forced into terminal extension with valgus stress.

Purpose of the Study:

• To describe the clinical presentation, diagnosis, and management of VEO and associated olecranon stress fractures.
• To outline conservative and surgical treatment options for these elbow injuries.
• To discuss the expected outcomes and return-to-sport rates for affected athletes.

Main Methods:

• Review of clinical presentations and diagnostic criteria for VEO and olecranon stress fractures.
• Discussion of conservative management, including rest and interval throwing programs.
• Overview of surgical interventions for refractory cases.

Main Results:

• Pain at the posteromedial olecranon tip is pathognomonic for VEO.
• Olecranon stress fractures, though rare, can cause significant dysfunction if untreated.
• Conservative treatment is the initial approach for both conditions.

Conclusions:

• VEO and olecranon stress fractures require prompt diagnosis and management in overhead athletes.
• A structured return-to-throwing program is crucial for recovery.
• Surgical options are available for cases unresponsive to conservative care, with good return-to-sport potential.