BackgroundAn increased carrying angle on the throwing side has been observed in professional pitchers.Elbow alignment is known to be a factor in the strain stress on the ulnar nerve.Ulnar nerve instability (UNI), in which the nerve snaps forward over the medial epicondyle during elbow flexion, is reportedly more common in pitchers than in other players.However, no studies have examined the association between elbow alignment and UNI severity in baseball players.This study assessed the correlation between the carrying angle (CA) and UNI severity in high school baseball pitchers. MethodsA total of 106 high school baseball pitchers who underwent medical checkups during the offseason in 2023 were examined.Ultrasound examinations were conducted to assess the presence or absence of UNI and medial joint space under rest and gravity stress on both sides of the elbow.The participants were divided into three groups based on the ultrasonographic findings of UNI: no instability (type N), subluxation (type S), and dislocation (type D).Clinical and physical examinations were performed, which included measurement of CA, grip strength, key pinch strength, and a check for ulnar nerve symptoms bilaterally. ResultsThe distribution of UNI types on the throwing side was 37%, 31%, and 32% for types N, S, and D, respectively.A similar distribution was found on the non-throwing side: 36% for Type N, 32% for Type S, and 32% for Type D. Overall, there was no statistically significant difference in the prevalence of these types between the two sides.The carrying angle of the throwing arm did not differ significantly between the three UNI groups: Type N (13.6 0.4), Type S (12.7 0.3), and Type D (12.0 0.3) (p=0.25).On the throwing side, the different UNI types did not show significant differences in the degree of ulnar collateral ligament (UCL) laxity or in other clinical and physical findings. J o u r n a l P r e -p r o o f ConclusionThis study found no significant difference in bony alignment, as indicated by the carrying angle, between the degrees of UNI among high school baseball pitchers.When categorized by UNI type, no significant differences were observed in the throwing side with respect to UCL laxity or other clinical and physical findings.
Hatori et al. (Sun,) studied this question.