Nonunion fracture of the sublime tubercle in a collegiate baseball pitcher: A case report

Abstract

Introduction: Elbow pathology including fractures to the coronoid process are common in overhead throwing athletes such as baseball pitchers. Only four cases have been reported of sublime tubercle avulsion fractures in the literature. This case study investigates a novel treatment for such injuries.Case Presentation: A 21-year-old collegiate baseball pitcher presented with medial elbow pain. Radiographic evaluation showed a nonunion fracture of the sublime tubercle of the coronoid process as well as medial epicondylitis and a partial ulnar collateral ligament (UCL) tear. The senior author performed platelet rich plasma injections into the origin of the flexor-pronator mass and UCL insertion. After an 8-week rehabilitation program, he was able to return to sport with no complications or drop in performance. Conclusion: Platelet-rich plasma injection may be a viable treatment option for management of patients with delayed union fractures to the sublime tubercle, medial epicondylitis and partial UCL tear.