棒球投手的肘傷

Pathomechanism of pitching elbow injuries could be analysed by studying of throwing mechanism. It is essential to understand the basic aspects of the pitching movement in order to recognize the different areas of stress concentration about the elbow. Elbow injuries generally occur during acceleration and follow- through phases. During the early acceleration, the elbow is placed in a position of extreme valgus stress. The extreme valgus stress can distract medial elbow structures, compress lateral elbow, and cause a wedging effect of the olecranon into olecranon fossa. Forearm pronation during late acceleration and follow-through can produce lateral compressive force on radiohumeral articulation. At the same time, the vigorous contraction of pronator teres may distract lateral epicondyle. During follow-through the hyperextension of elbow not only makes olecranon impinge posteriorly into olecranon fossa but also stresses the anterior capsule and coronoid process. All these forces can cause injuries of soft tissue around elbow, bone structures or ulnar nerve. Most of the articles relating to treatment of elbow injuries concerned about surgical intervention. Since prevention is the bes' treatment, it is important to do good conditioning exercises, to increase or maintain adequate muscle strength as well as good flexibility, and to perform proper throwing mechanism.