Vascular Problems in Elite Throwing Athletes

J Hand Surg Am. 2023 Jan;48(1):68-75. doi: 10.1016/j.jhsa.2022.08.016. Epub 2022 Oct 18.

Abstract

There are approximately 880 and 3,600 major league baseball and minor league baseball players who currently are active in their respective leagues, with thousands of players in the collegiate, high school, and little league ranks. Although relatively uncommon, vascular injuries, such as thoracic outlet syndrome, axillary artery compression, quadrilateral space syndrome, and direct vascular trauma, can afflict these players. These career- and limb-threatening injuries can mimic often seen muscular sprains and strains in their early stages with nonspecific symptoms, such as exertional fatigue, which can delay diagnosis with disastrous sequelae, including thrombus propagation, aneurysm rupture, and ischemia from distal embolization. The goal of this review is to discuss the pathophysiology, diagnosis, and treatment of these injuries to increase awareness of sport-related vascular phenomena among the hand and upper-extremity surgery community because these players typically are seen first in the training room or a hand specialist's office.

Keywords: Baseball pitchers; digital ischemia; quadrilateral space syndrome; repetitive finger trauma; vascular thoracic outlet syndrome.

Publication types

  • Review

MeSH terms

  • Athletes
  • Baseball* / injuries
  • Hand / blood supply
  • Humans
  • Sports*
  • Upper Extremity
  • Vascular Diseases*