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Shoulder and Elbow Injuries in the Adolescent Throwing Athlete.

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Adolescent shoulder and elbow injuries differ based on growth plate maturity. Recognizing skeletally immature (open growth plate) versus mature (closed growth plate) injuries is crucial for appropriate management and preventing long-term complications.

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Area of Science:

  • Orthopedics
  • Sports Medicine
  • Pediatric Sports Injuries

Background:

  • Adolescent athletes face unique shoulder and elbow injuries.
  • Injuries are categorized by skeletal maturity: skeletally immature (open growth plate) and skeletally mature (closed growth plate).
  • Skeletally immature injuries pose risks of growth disturbance if not managed properly.

Purpose of the Study:

  • To differentiate between skeletally immature and mature shoulder and elbow injuries in adolescents.
  • To identify at-risk patient populations for each injury type.
  • To outline distinct treatment strategies and return-to-play guidelines.

Main Methods:

  • Review of common skeletally immature injuries: Little League elbow, medial epicondyle fractures, olecranon stress fractures, capitellar osteochondritis dissecans (OCD), and Little League shoulder.
  • Review of common skeletally mature injuries: valgus extension overload syndrome (VEOS), ulnar collateral ligament (UCL) tears, shoulder instability, and SLAP tears.
  • Discussion of injury history, presentation, treatment options, and return-to-play protocols.

Main Results:

  • Skeletally immature injuries involve the growth plate, with potential for growth disturbance.
  • Skeletally mature injuries occur in athletes with closed growth plates and generally do not affect growth.
  • Specific injury types and their management differ significantly between the two groups.

Conclusions:

  • Accurate classification of adolescent shoulder and elbow injuries based on skeletal maturity is essential.
  • Tailored treatment and rehabilitation are necessary to optimize outcomes and prevent long-term issues.
  • This review provides guidance for sports physicians and orthopedic surgeons on managing these distinct injury patterns.