title: Avulsion fracture of the ulnar sublime tubercle in overhead throwing athletes.
abstract: BACKGROUND
  Injuries to the ulnar collateral ligament are relatively common in throwing athletes and result from either acute traumatic or repeated valgus stress to the elbow. Avulsion fracture of the sublime tubercle of the ulna is a rarely reported site of ulnar collateral ligament injury.
  
  
  OBJECTIVE
  We retrospectively reviewed our cases of ulnar collateral ligament injuries to study avulsion fractures of the sublime tubercle of the ulna.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Data, including radiographs and magnetic resonance imaging scans, were obtained by review of hospital and office records and by follow-up examination. Of 33 consecutive patients treated for ulnar collateral ligament injuries, 8 had avulsion fractures of the sublime tubercle of the ulna. All eight were male baseball players with dominant arm involvement, an average age of 16.9 years, and an average follow-up of 23.6 months.
  
  
  RESULTS
  Six of eight patients had failure of nonoperative treatment and required surgical repair. Two of the six underwent ulnar collateral ligament reconstruction and four had direct repair of the sublime tubercle avulsion with bioabsorbable suture anchors. At last follow-up, all eight had returned to their preinjury level of activity. No patient had residual medial elbow pain or laxity.
  
  
  CONCLUSIONS
  Diagnosis of sublime tubercle avulsion fracture is made with history, physical examination, and radiographic studies. Magnetic resonance imaging can help identify an avulsion fracture not visible radiographically and can help determine whether direct repair or reconstruction is needed.
authors.affiliation: Uribe-Hechtman-Zvijac Sports Medicine Institute, 1150 Campo Sano Avenue, Suite 200, Coral Gables, FL 33146, USA.
authors.forename: John P
authors.initials: JP
authors.lastname: Salvo
authors.forename: Louis
authors.initials: L
authors.lastname: Rizio
authors.forename: John E
authors.initials: JE
authors.lastname: Zvijac
authors.forename: John W
authors.initials: JW
authors.lastname: Uribe
authors.forename: Keith S
authors.initials: KS
authors.lastname: Hechtman
mesh_terms: D000293:Adolescent; D000328:Adult; D001175:Arthrography; D001265:Athletic Injuries / Q000175:diagnosis / Q000628:therapy; D001484:Baseball / Q000293:injuries*; D004551:Elbow Joint / Q000503:physiopathology; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods; D010146:Pain / Q000503:physiopathology; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome; D014458:Ulna Fractures / Q000175:diagnosis / Q000628:therapy*