Clin Orthop Surg.  2017 Dec;9(4):537-541. 10.4055/cios.2017.9.4.537.

Little Leaguer's Shoulder Can Cause Severe Three-Dimensional Humeral Deformity

• Hosokawa Y
• Mihata T
• Itami Y
• Neo M
• Doi M

• KMID: 2412257
• DOI: http://doi.org/10.4055/cios.2017.9.4.537

Abstract

We analyzed three-dimensional (3D) humeral deformity (valgus-varus, flexion-extension, and rotational deformation) after little leaguer's shoulder using 3D computed tomography in a 15-year-old male baseball player. Humeral retroversion was increased by 27.1° on the dominant side compared with the nondominant side. Compared with the nondominant shaft, the dominant humeral shaft was deformed in the varus direction (9.4°), resulting in a decreased neck-shaft angle (dominant side, 127.5°; nondominant side, 135.1°), and it was also deformed in the extension direction (21.0°). This case demonstrates that little leaguer's shoulder can cause markedly greater humeral retroversion than has been reported previously and can result in varus and extension deformation of the humerus. These findings suggest that humeral deformity in overhead throwing athletes may not always solely reflect adaptation to throwing.

Keyword

Computed tomography; Humeral deformity; Little leaguer's shoulder; Three-dimensional

MeSH Terms

Adolescent
Baseball/*injuries
Humans
Humerus/*diagnostic imaging/injuries/*pathology
Imaging, Three-Dimensional
Male
Salter-Harris Fractures/*complications
Tomography, X-Ray Computed

Figure

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  Fig. 1 Plain radiographs in neutral rotation of the patient's shoulder (age, 13 years). (A) Physeal widening in the proximal humerus on the dominant side due to little leaguer's shoulder. (B) Proximal humerus on the nondominant side. (C) After 2 months of rest from throwing, the appearance of the proximal physis became normal and the patient was able to resume throwing without shoulder pain.

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  Fig. 2 Three-dimensional surface models of the dominant (blue) and nondominant (white) proximal humeri. (A) Anterior view. (B) Lateral view. (C) Posterior view.

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  Fig. 3 Three-dimensional surface models of the dominant (blue) and nondominant (white) proximal humeri superior to the physis. Anterior (A), lateral (B), posterior (C), superior (D), and inferior (E) views.

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  Fig. 4 Three-dimensional surface models of the dominant (blue) and nondominant (white) proximal humeri. (A) Posterior view. Humeral retroversion was increased by 27.1° on the dominant side compared with the nondominant side when the image of the dominant humeral shaft was superimposed on the corresponding mirror image of the nondominant side. (B) Anterior view. The dominant humeral shaft was deformed in the varus direction by 9.4° when the image of the dominant humeral head was superimposed on the corresponding mirror image of the nondominant side. (C) Lateral view. The dominant humeral shaft was deformed in the extension direction by 21.0° when the image of the dominant humeral head was superimposed on the corresponding mirror image of the nondominant side.

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