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Review
. 2023 May;52(5):404-412.
doi: 10.1007/s00132-023-04375-5. Epub 2023 Apr 24.

[Return to throwing sports after upper extremity injury and overuse : A criteria-based approach using an ulnar collateral ligament injury as an example]

[Article in German]
Matthias Keller  1 , Andreas Lenich  2 , Tim Saier  3 , Eduard Kurz  4   5
Affiliations
Review

[Return to throwing sports after upper extremity injury and overuse : A criteria-based approach using an ulnar collateral ligament injury as an example]

[Article in German]
Matthias Keller et al. Orthopadie (Heidelb). 2023 May.

Abstract
in English, German

Background: Uniform procedures for rehabilitation and follow-up treatment after injuries and surgeries at the upper extremity do not exist. Accordingly, only a few approaches for the follow-up treatment of instabilities of the elbow joint have been described.

Objectives: The authors show how rehabilitation before sport-specific training after rupture of the ulnar collateral ligament in a female handball player was objectivized and controlled using the results of functional tests.

Materials and methods: The follow-up treatment of a semi-professional female handball player (aged 20) after rupture of the ulnar collateral ligament was objectivized and controlled using the return to activity algorithm. In addition to the comparisons with the values of the unaffected side, comparative results of 14 uninjured female handball players were used for guidance.

Results/conclusions: The patient was able to participate fully in sport-specific training after 15 weeks and participate in her first competitive match after 20 weeks. On the affected side, she achieved a distance of 118% of her upper limb length on the medial reach of the upper quarter Y balance test and 63 valid contacts on the wall hop test. The values achieved at the end of rehabilitation were higher than the average values of the control group.

Zusammenfassung: HINTERGRUND: Einheitliche Vorgehensweisen bei der Rehabilitation und Nachbehandlung nach Verletzungen und Operationen an der oberen Extremität existieren nicht. Entsprechend gibt es für die Nachbehandlung von Instabilitäten am Ellenbogen nur wenig beschriebene Ansätze.

Fragestellung: Die Autoren zeigen, wie die Rehabilitation vor dem sportartspezifischen Training nach einer Ruptur des Ligamentum collaterale ulnare bei einer Handballerin mittels Ergebnisse funktioneller Tests objektiviert und gesteuert werden kann.

Material und methode: Die Nachbehandlung einer semiprofessionellen Handballspielerin (20 Jahre) nach Ruptur des Ligamentum collaterale ulnare wurde mittels des „Return-to-activity“-Algorithmus objektiviert und gesteuert. Neben dem Seitenvergleich konnte zur Orientierung auf Vergleichswerte von 14 unverletzten Handballspielerinnen zurückgegriffen werden.

Resultate/schlussfolgerungen: Die Patientin konnte nach 15 Wochen wieder vollumfänglich am Handballtraining teilnehmen und nach 20 Wochen den ersten Wettkampf bestreiten. Auf der betroffenen Seite erreichte sie beim „medial reach“ des Y‑Balance-Tests für die obere Extremität eine Distanz von 118 % der eigenen Armlänge und beim Wall-Hop-Test 63 gültige Kontakte. Die erreichten Werte lagen am Ende der Rehabilitation über den Durchschnittswerten der Kontrollgruppe.

Keywords: Elbow; Rehabilitation; Return to sport; Sports injuries; Upper limb.

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