title: Valgus extension overload syndrome in adolescent baseball players: clinical characteristics and surgical outcomes.
abstract: BACKGROUND
  Little is known about the clinical characteristics and surgical outcomes of valgus extension overload syndrome (VEOS) in adolescent athletes. We evaluated posteromedial compartment pathology, including combined lesions, and reported the surgical outcomes in adolescent baseball players.
  
  
  METHODS
  We retrospectively reviewed the medical records of 13 male adolescent baseball players (mean age, 15.4 years) who underwent arthroscopic olecranon tip resection (n = 9) or staged operations (arthroscopic olecranon tip resection, followed by medial collateral ligament reconstruction 2 weeks later; n = 4). The shape of the tip fragment was used to classify the olecranon into 2 types: type 1, dot-like fragment (n = 3); type 2, triangular-shape fragment (n = 10). Four outcome measures were analyzed: range of motion, visual analog scale (VAS) pain score, rate of return to play, and Conway scale score.
  
  
  RESULTS
  At a mean follow-up of 3.3 years (range, 2-6 years), the mean VAS pain score decreased from 4.1 preoperatively to 1.1 postoperatively (P < .05). Preoperative mean extension and supination were 4.2° and 70.0°, which improved to 1° (P < .05) and 76.2° (P < .05), respectively. The overall rate of return to play was 85% (11 of 13). On the Conway scale, 8 of 13 patients (62%) were classified as excellent. Patients who underwent isolated arthroscopic surgery reported less pain postoperatively and achieved a higher grade on the Conway scale than patients who underwent staged operations.
  
  
  CONCLUSIONS
  Arthroscopic resection of olecranon tip yielded favorable outcomes at a minimum of 2 years of follow-up. Patients with concomitant ulnar collateral ligament insufficiency had less optimal outcomes than those with isolated posteromedial impingement.
authors.affiliation: Neon Orthopaedic Surgery, Seoul, Republic of Korea.
authors.forename: Jin-Young
authors.initials: JY
authors.lastname: Park
authors.affiliation: LeeChunTek Orthopaedic Specialty Hospital, Suwon, Republic of Korea.
authors.forename: Hyun-Yul
authors.initials: HY
authors.lastname: Yoo
authors.affiliation: Department of Orthopaedics, Konkuk University School of Medicine, Seoul, Republic of Korea.
authors.forename: Seok Won
authors.initials: SW
authors.lastname: Chung
authors.affiliation: Department of Orthopaedics, Konkuk University School of Medicine, Seoul, Republic of Korea.
authors.forename: Seung-Jun
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Department of Orthopaedics, Konkuk University School of Medicine, Seoul, Republic of Korea.
authors.forename: Na Ra
authors.initials: NR
authors.lastname: Kim
authors.affiliation: Department of Orthopaedics, Konkuk University School of Medicine, Seoul, Republic of Korea.
authors.forename: Se-Young
authors.initials: SY
authors.lastname: Ki
authors.affiliation: Department of Orthopaedics, Konkuk University School of Medicine, Seoul, Republic of Korea; Department of Orthopaedics, Korea University College of Medicine, Seoul, Republic of Korea. Electronic address: orthopaedics11@gmail.com.
authors.forename: Kyung-Soo
authors.initials: KS
authors.lastname: Oh
mesh_terms: D000293:Adolescent; D001182:Arthroscopy; D001484:Baseball / Q000293:injuries*; D000070637:Collateral Ligament, Ulnar / Q000293:injuries / Q000601:surgery; D012090:Cumulative Trauma Disorders / Q000601:surgery*; D004551:Elbow Joint / Q000601:surgery*; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000601:surgery; D006801:Humans; D008297:Male; D056740:Olecranon Process / Q000293:injuries / Q000601:surgery; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D000068958:Return to Sport; D064232:Visual Analog Scale
keywords: Adolescent; baseball player; medial collateral ligament; posteromedial compartment; surgical outcomes; tip fragment; valgus extension overload