Posterolateral Elbow Impingement in Professional Boxers

Abstract

BACKGROUND: Elbow injury is common in boxing, but it has not been reported in the literature. The onset is often a hyperextension trauma caused by a missed hit. Clinically the boxers complain of pain, stiffness, and an extension deficit. PURPOSE: To evaluate the pathogenesis, diagnostic approach, and arthroscopic treatment of elbow injury in boxers, and to compare these with other sports-related elbow injuries. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Between 2003 and 2005, a group of 5 professional boxers received a diagnosis of posterior elbow impingement. An arthroscopic debridement was performed. All patients were evaluated preoperatively and 1 year postoperatively with the Hospital for Special Surgery Elbow Assessment Scale. RESULTS: An arthroscopic partial resection of the posterior olecranon tip was performed, and osteophytes and fibrous tissue were removed in this area. Loose bodies were removed from the elbow in 3 patients. They were present in the posterior compartment in 2 patients and the anterior compartment in 1. The Hospital for Special Surgery score showed satisfactory to good improvement after 1 year in all 5 cases. They all showed a normal function at follow-up and had a full return to their sports activities. In contrast with the valgus extension overload syndrome, our patients did not show any signs of concomitant ulnar collateral ligament injury. CONCLUSION: Posterolateral elbow impingement in boxers is caused by hyperextension trauma. Concomitant medial elbow instability was not present. Standard arthroscopic debridement showed good results.