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Recurrent Medial Elbow Pain Following Successful Tommy John Surgery

Mark H. Greenberg, MD, RMSK, RhMSUS, A. Lee Day, MD, RMSK, James W. Fant Jr., MD, & Christopher G. Mazoue, MD  |  Issue: August 2020  |  

Ulnar Nerve Relocation: A New Syndrome?

Elements of this proposed syndrome would be: sonographic demonstration of ulnar nerve dislocation pushed by a hypertrophied and dislocating MHTr muscle, with pain occurring at the end of rapid elbow extension.

The typical clinical setting would be in a professional athlete who repetitively throws.

 

References

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  3. Bjerre JJ, Johannsen FE, Rathcke M, Krogsgaard MR. Snapping elbow—A guide to diagnosis and treatment. World J Orthop. 2018 Apr 18;9(4):65–71.
  4. Jacobson JA, Jebson PJ, Jeffers AW, et al. Ulnar nerve dislocation and snapping triceps syndrome: Diagnosis with dynamic sonography—report of three cases. Radiology. 2001 Sep;220(3):601–605.
  5. Jobe FW, Stark H, Lombardo SJ. Reconstruction of the ulnar collateral ligament in athletes. J Bone Joint Surg Am. 1986 Oct;68(8):1158–1163.
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  7. Leland DP, Conte S, Flynn N, et al. Prevalence of medial ulnar collateral ligament surgery in 6135 current professional baseball players: A 2018 update. Orthop J Sports Med. 2019 Sep 25;7(9):2325967119871442.
  8. Gutierrez NM, Granville C, Kaplan L, et al. Elbow MRI findings do not correlate with future placement on the disabled list in asymptomatic professional baseball pitchers. Sports Health. 2017 May/Jun;9(3):222–229.
  9. Garcia GH, Gowd AK, Cabarcas BC, et al. Magnetic resonance imaging findings of the asymptomatic elbow predict injuries and surgery in Major League Baseball pitchers. Orthop J Sports Med. 2019 Jan 20;7(1):2325967118818413.
  10. Cobb F. IV. Report of a case of recurrent dislocation of the ulnar nerve cured by operation: With summary of previously reported cases. Ann Surg. 1903;38(5):652–663.
  11. Lazaro L 3rd. Ulnar nerve instability: Ulnar nerve injury due to elbow flexion. South Med J. 1977 Jan;70(1):36–40.
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