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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Stress Fractures of the Elbow in the Throwing Athlete: A Systematic Review
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Stress Fractures of the Elbow in the Throwing Athlete: A Systematic Review

机译：投掷运动员肘部的应力性骨折：系统评价

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Background: Stress fractures of the elbow are rare in throwing athletes and present a challenge from both a management and rehabilitation perspective. Although the incidence of stress fractures of the elbow is increasing, there is a lack of data in the literature focused on throwers. Purpose: To evaluate studies regarding the management and outcomes of stress fractures of the elbow in throwing athletes. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was conducted by searching the Scopus, PubMed, and Cochrane Library electronic databases to identify studies reporting on the management and outcomes of stress fractures in overhead-throwing athletes. Management data included nonoperative and operative modalities, and outcome data included return to play, encompassing the timing and level of activity. Studies were excluded if the stress fracture of the elbow was not a result of a sport injury attributed to throwing or if the study failed to report whether an athlete returned to play. Results: Fourteen studies met the inclusion criteria and were included in this analysis. There were 52 patients in total (50 male, 2 female) with a mean age of 19.7 years (range, 13-29.1 years). The olecranon was the most common location of the stress fracture (51 patients; 98.1%), followed by the distal humerus (1 patient; 1.9%). The majority of patients (n = 40; 76.9%) were treated operatively. Of the 40 patients who were treated surgically, 14 (35.0%) underwent a period of conservative treatment preoperatively that ultimately failed because of persistent nonunion or continued elbow pain. A total of 50 patients (96.2%) returned to sport either at or above their preinjury level. Of the 2 patients (3.8%) who did not return to sport, 1 did not return because of continued elbow pain postoperatively, and the other was lost to follow-up. Complications occurred in 9 patients (17.3%), all of whom were treated surgically. Conclusion: On the basis of this systematic review, the majority of elbow stress fractures were treated operatively and approximately one-third after a period of failed nonoperative management. The return-to-sport rate was high. Further, higher level studies are needed to optimize management and return-to-sport rates in this population.
机译：背景：肘部应力性骨折在投掷运动员中很少见，从管理和康复的角度来看都是一个挑战。尽管肘部应力性骨折的发生率正在增加，但文献中缺乏有关投掷者的数据。目的：评估有关投掷运动员肘部应力性骨折的处理和结果的研究。研究设计：系统评价;证据等级：4。方法：通过检索Scopus，PubMed和Cochrane图书馆的电子数据库进行系统的审查，以鉴定报告架空运动员应力性骨折的管理和结果的研究。管理数据包括非手术和手术方式，结果数据包括重返比赛，包括活动的时间和水平。如果肘部的应力性骨折不是由于摔跤造成的运动损伤或由于该研究未能报告运动员是否重返比赛而进行的研究，则排除该研究。结果：14项研究符合纳入标准，被纳入此分析。总共有52例患者（男50例，女2例），平均年龄19.7岁（范围13-29.1岁）。鹰嘴骨是应力性骨折最常见的部位（51例; 98.1％），其次是肱骨远端（1例; 1.9％）。大多数患者（n = 40; 76.9％）接受了手术治疗。在接受手术治疗的40例患者中，有14例（35.0％）在术前接受了保守治疗，由于持续的不愈合或持续的肘部疼痛而最终失败。共有50名患者（96.2％）在受伤前或受伤后恢复运动。 2例（3.8％）未恢复运动的患者中，1例由于术后持续的肘部疼痛而没有恢复，另一例因随访而丧失。 9例患者发生并发症（17.3％），所有患者均接受手术治疗。结论：在此系统评价的基础上，大多数肘部应力性骨折都得到了手术治疗，并且在一段非手术治疗失败后约有三分之一得到了治疗。返程率很高。此外，需要进行更高水平的研究来优化该人群的管理和体育回归率。

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