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Principles of Surgical Evaluation and Techniques for the Elbow in the Overhead Athlete

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Mechanics, Pathomechanics and Injury in the Overhead Athlete

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Abstract

Appropriate orthopedic management of elbow pathologies in the athlete requires thoughtful history-taking, thorough physical examination, and well-selected diagnostic imaging. Obtaining a thorough history of an overhead athlete should include past injuries and treatments to the elbow as well as the remainder of the kinetic chain (shoulder, core, hips, and legs). Physical examination of such athletes should involve evaluation of the neck/cervical spine, both shoulder girdles (clavicles with associated joints, scapulae, and glenohumeral joints), both elbows, and the remainder of the kinetic chain, including inspection, palpation, range of motion, strength and sensation testing, as well as special provocative maneuvers. Diagnostic imaging may begin with plain radiographs but will often require advanced modalities such as ultrasound, computed tomography, and magnetic resonance imaging. This thorough evaluation will allow the clinician to confirm the suspected diagnosis as well as thoroughly exclude alternative or potential concomitant diagnoses. This chapter will review the surgical management of five elbow pathologies common among overhead throwing athletes: ulnar collateral ligament injury, medial elbow tendinopathy/epicondylitis, lateral elbow tendinopathy/epicondylitis, distal biceps injury, and distal triceps injury.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Thomas Jefferson University Hospital and the Rothman Institute, Philadelphia, PA, USA

    Michael C. Ciccotti

  2. Division of Sports Medicine, Sports Medicine Research, Department of Orthopaedic Surgery, The Rothman Institute, The Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA

    Steven B. Cohen

  3. Philadelphia Phillies, Philadelphia, PA, USA

    Steven B. Cohen

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  1. Michael C. Ciccotti
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  2. Steven B. Cohen
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Correspondence to Michael C. Ciccotti .

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Editors and Affiliations

  1. Shoulder Center of Kentucky, Lexington Clinic, Lexington, KY, USA

    W. Ben Kibler

  2. Eastern Kentucky University, Richmond, KY, USA

    Aaron D. Sciascia

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Ciccotti, M.C., Cohen, S.B. (2019). Principles of Surgical Evaluation and Techniques for the Elbow in the Overhead Athlete. In: Kibler, W., Sciascia, A. (eds) Mechanics, Pathomechanics and Injury in the Overhead Athlete. Springer, Cham. https://doi.org/10.1007/978-3-030-12775-6_7

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