Management of Pediatric and Adolescent Sublime Tubercle Injuries: Isolated and Complex Patterns Demonstrate Distinct...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Pediatric Orthopedics

Background:

• Sublime tubercle avulsion injuries are rare elbow injuries.
• Previous descriptions focused on noncontact mechanisms in baseball players.

Purpose of the Study:

• To assess patient demographics, injury mechanisms, and natural history of sublime tubercle avulsion injuries.
• To classify these injuries and compare outcomes based on injury type.

Main Methods:

• Multicenter retrospective case series (Level IV evidence).
• Reviewed demographic data, injury mechanisms, and imaging for 40 adolescent patients.
• Classified injuries as Type 1 (isolated) or Type 2 (complex with associated fracture/dislocation).

Main Results:

• Median age of 15 years, 78% male.
• Type 1 injuries (68%) often noncontact in overhead athletes; Type 2 (32%) always contact.
• Type 1 injuries showed healing with immobilization (82%); Type 2 injuries often required surgery (54%).

Conclusions:

• Sublime tubercle avulsion injuries have diverse epidemiology and mechanisms.
• Type 1 injuries typically heal with nonoperative management (immobilization).
• Type 2 injuries more often need surgical intervention and have poorer nonoperative healing outcomes.