Pediatric emergency medicine trisk 3953 3953
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FIGURE 121.9 Avulsion of the inferior pole of the patella in a 10-year-old child with SindingLarsen–Johansson disease.
Little Leaguer Elbow
Little Leaguer elbow refers to a group of disorders resulting from repetitive
valgus stress applied to the skeletally underdeveloped elbow. The cause of these
injuries is multifactorial and includes the number of pitches thrown per outing,
the number of outings, type of pitches thrown, throwing technique, and degree of
skeletal maturity. Valgus force places tension on the medial collateral ligaments,
which is translated to the medial epicondyle. A medial epicondylitis or
apophysitis is the most commonly resulting lesion. An avulsion fracture of the
medial epicondyle may result from an acute valgus force once the site has
