骨軟骨障害を認める成長期内側型投球障害肘の検討

Apophyseopathy of Humeral Medial Epicondyle in the Adolescent Baseball Player

　成長期内側型投球障害肘を成長終了まで縦断的に追跡し，その予後を検討した．内側上顆分節化を認める骨端線未閉鎖の32例を対象とした．まずは投球中止により外反ストレスを回避した．圧痛が消失すれば投球を許可したが，復帰に際しては障害が残存していることを認識させ，再発予防のためにコンディショニング，投球フォーム指導を行った．平均2.1カ月で野球に復帰し，最終的に31例で骨癒合を得ていた．骨癒合時期はほぼ成長終了時期に一致していた．

　We evaluated the results of conservative treatment of apophyseopathy of the medial epicondyle of the humerus after skeletal maturity in 32 adolescent baseball players. The initial X-ray films showed fragmentation of the medial epicondylar epiphysis in every case. Valgus stress of the elbow was avoided by not throwing balls. We instructed the patients in throwing form and conditioning of the elbow, the shoulder, the spine, and the hip. After the tenderness of the medial epicondyle had resolved, ball throwing was permitted. The patients resumed playing baseball after an average of 2.1 months, and osseous union was achieved in 31 of the 32 cases after skeletal maturation. These results show that adequate conditioning guidance is important to the treatment of apophyseopathy of the medial epicondyle of the humerus in adolescent baseball players.