HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Sign In to gain access to subscriptions and/or personal tools.

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by DiFelice, G. S. Articles by Wright, R. W. Search for Related Content PubMed PubMed Citation Articles by DiFelice, G. S. Articles by Wright, R. W. Related Collections Baseball

Effort Thrombosis in the Elite Throwing Athlete

Gregory S. DiFelice, MD^*, George A. Paletta, Jr, MD^*, Barry B. Phillips, MD and Rick W. Wright, MD^*,

^* Department of Orthopaedic Surgery, Washington University School of Medicine at Barnes-Jewish Hospital, St. Louis, Missouri
Campbell Clinic, Germantown, Tennessee

Address correspondence and reprint requests to Rick W. Wright, MD, Department of Orthopaedic Surgery, Washington University School of Medicine, 1 Barnes-Jewish Hospital Plaza, Suite 11300 WP, St. Louis, MO 63110

Background: Upper extremity vascular injuries are uncommon in the elite throwing athlete. However, the extreme stresses that are placed on the upper extremity of elite baseball players, especially pitchers, puts them at risk for such injuries. One such injury is upper extremity venous thrombosis or "effort thrombosis."

Purpose: We wanted to review the common initial clinical symptoms and physical examination findings of effort thrombosis in elite baseball players and to review the associated clinical conditions such as hypercoagulable states and pulmonary embolism.

Study Design: Retrospective review of a series of cases.

Methods: A retrospective review of the medical records of a Major League Baseball organization and a Division I college was performed for the period 1987 to 1997.

Results: We located four cases of effort thrombosis involving elite baseball players. Contrast venography was used to confirm the diagnosis in all cases. All patients were successfully treated with transluminal catheter-directed urokinase thrombolysis followed by first rib resection and systemic anticoagulant therapy for up to 3 months. All four players returned to play at or above their previous level of competition with no long-term chronic sequelae.

Conclusions: Prompt clinical recognition, diagnosis, and treatment of effort thrombosis in the elite baseball player provides the player with an excellent prognosis for return to the previous level of play.

This article has been cited by other articles:

				J. G. Hurbanek, K. Anderson, S. Kaatz, A. Shepard, M. Workings, and K. Rand Ulnar Deep Venous Thrombosis in a Professional Baseball Pitcher: A Case Report Am. J. Sports Med., December 1, 2007; 35(12): 2131 - 2134. [Full Text] [PDF]

				S. M. Aval, P. Durand Jr, and J. A. Shankwiler Neurovascular Injuries to the Athlete's Shoulder: Part II J. Am. Acad. Ortho. Surg., May 1, 2007; 15(5): 281 - 289. [Abstract] [Full Text] [PDF]