Little League survey: the Houston study

Area of Science:

• Orthopedics
• Sports Medicine
• Pediatric Sports Medicine

Background:

• Little League elbow is a common concern for young athletes.
• Understanding the relationship between pitching, elbow symptoms, and radiographic findings is crucial.

Purpose of the Study:

• To investigate the prevalence of elbow symptoms and radiographic abnormalities in Little League pitchers.
• To determine correlations between pitching experience, elbow symptoms, and radiographic findings.

Main Methods:

• A cross-sectional study involving 595 Little League pitchers.
• Assessment of elbow symptoms, range of motion, carrying angle, and radiographic evaluations.
• Analysis of correlations between clinical and radiographic findings and pitching history.

Main Results:

• 17% of pitchers reported elbow symptoms, but only 1% were ever excluded from pitching.
• Elbow extension limitation (12%) and valgus carrying angle were common but not correlated with symptoms or experience.
• No avascular necrosis was observed; bony hypertrophy and medial epicondyle enlargement were considered normal variants.
• Undisplaced medial epicondyle stress fractures showed good response to conservative treatment.

Conclusions:

• Most elbow symptoms in young pitchers are not career-limiting.
• Many radiographic findings are normal anatomic variants unrelated to symptoms.
• Conservative management is effective for undisplaced medial epicondyle stress fractures.