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First published on November 6, 2007, doi:10.1177/0363546507308937
This version was published on February 1, 2008
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The American Journal of Sports Medicine 36:328-332 (2008)
© 2008 American Orthopaedic Society for Sports Medicine

Posterolateral Elbow Impingement in Professional Boxers

Kars P. Valkering, MD{dagger},*, Henk van der Hoeven, MD{ddagger} and Bas C. M. Pijnenburg, MD, PhD§

From the {dagger} Department of Orthopaedic Surgery, Spaarne Hospital, Hoofddorp, the Netherlands, the {ddagger} Department of Orthopaedic Surgery, St Antonius Hospital, Nieuwegein, the Netherlands, and the § Department of Orthopaedic Surgery, Diakonessen Hospital Utrecht, Utrecht, the Netherlands

* Address correspondence to Kars P. Valkering, MD, Department of Orthopaedic Surgery, Spaarne Hospital, PO Box 770, 2130 AT Hoofddorp, the Netherlands (e-mail: kars.valkering{at}gmail.com).

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.

Key Words: arthroscopy • boxing • elbow • hyperextension • impingement • ulnar collateral ligament • valgus extension overload syndrome






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