目的:建立尺侧副韧带(UCL)损伤治疗的共识声明,并研究是否可以就这些不同主题达成共识。
方法:在26名肘外科医生和3名物理治疗师/运动教练中进行了改良的共识技术。强烈的共识被定义为90%到99%的共识。
结果:在19个问题和共识声明中,有4个达成了一致共识,13达成强烈共识,2没有达成共识。
结论:一致同意风险因素包括过度使用,高速,力学差,以前的伤害。一致认为,对于怀疑/已知的UCL泪液计划继续进行头顶运动的患者,应进行磁共振成像或磁共振关节镜检查形式的高级成像。或者影像学研究是否可以改变患者的管理。关于在UCL眼泪的治疗中缺乏使用直管生物学的证据以及投手在尝试非手术治疗时应关注的领域,达成了一致意见。就手术管理达成一致意见的声明是关于UCL眼泪的手术适应症和禁忌症,进行UCL手术时应考虑的预后因素,在UCL手术期间如何处理屈前肌肿块,使用内部撑杆和UCL维修。在确定是否允许运动员参加RTS时,应考虑达成关于重返运动(RTS)的一致意见的部分身体检查;不清楚速度如何,准确度,和旋转速率应考虑到决定何时球员可以RTS和运动心理测试应用于确定球员是否准备好RTS。
方法:V,专家意见。
To establish
consensus statements on the treatment of ulnar collateral ligament (UCL) injuries and to investigate whether
consensus on these distinct topics could be reached.
A modified consensus technique was conducted among 26 elbow surgeons and 3 physical therapists/athletic trainers. Strong
consensus was defined as 90% to 99% agreement.
Of the 19 total questions and
consensus statements 4 achieved unanimous
consensus, 13 achieved strong
consensus, and 2 did not achieve
consensus.
There was unanimous agreement that the risk factors include overuse, high velocity, poor mechanics, and previous injury. There was unanimous agreement that advanced imaging in the form of either magnetic resonance imaging or magnetic resonance arthroscopy should be performed in a patient presenting with suspected/known UCL tear that plans to continue to play an overhead sport, or if the imaging study could change the management of the patient. There was unanimous agreement regarding lack of evidence for the use of orthobiologics in the treatment of UCL tears as well as the areas pitchers should focus on when attempting a course of nonoperative management. The statements that reached unanimous agreement for operative management were regarding operative indications and contraindications for UCL tears, prognostic factors that should be taken into consideration in when performing UCL surgery, how to deal with the flexor-pronator mass during UCL surgery, and use of an internal brace with UCL repairs. Statements that reached unanimous agreement for return to sport (RTS) were regarding portions of the physical examination should be considered when determining whether to allow a player to RTS; unclear how velocity, accuracy, and spin rate should be factored into the decision of when players can RTS and sports psychology testing should be used to determine whether a player is ready to RTS.
V, expert opinion.