少棒肩重新审视：过去十年的系统综述。
完整摘要 · 中文译文
背景：累及肩部骺板生长复合体的骺板应力性损伤，称为少年棒球肩（LLS），主要发生于骨骼未成熟的过顶投掷运动员。 数据来源：本系统综述纳入了过去10年内（2015年1月1日至2025年9月23日）发表的关于LLS的研究，来源为四个电子数据库（Embase、PubMed、SPORTDiscus、Cochrane Library），聚焦于诊断、管理、影像学及重返运动标准。 共识领域：LLS主要见于11-15岁骨骼未成熟的男性过顶投掷运动员。早期专项化、参加多支球队及休息不足是已报道的危险因素。LLS通常表现为投掷相关肩痛、肱骨近端骺板压痛、后关节囊紧张及肩胛运动障碍。X线仍是首选影像学检查，显示外侧骺板增宽和不规则。停止投掷2-4个月，随后进行康复和逐步恢复投掷，可获得良好的短期预后，生长障碍发生率低。预防策略包括投球数限制、休息、正确的投掷力学及延迟专项化。 争议领域：由于诊断标准、影像学使用及报告不足的差异，LLS的患病率仍不明确。复发率和长期后遗症在各研究间不一致，运动员停止棒球运动的原因仍不确定。关于正式康复与单纯休息相比的获益，证据存在矛盾。 进展要点：先进影像学去 证明肩部存在结构重塑，提示骨骼未成熟期的重复负荷会影响长期形态和力学。 及时开展研究的领域：采用临床和影像学标准的前瞻性研究可能有助于确定发病率、严重程度、危险因素、运动特异性模式，并阐明症状缓解、肱骨重塑及影响脱队（attrition）的因素。纵向研究应比较休息与结构化康复以及不同的重返投掷方案。
完整摘要 · 英文原文
BACKGROUND: Physeal stress injuries involving the shoulder epiphyseal growth plate complex, known as Little League Shoulder (LLS), occur primarily in skeletally immature overhead athletes. SOURCES OF DATA: This systematic review included research on LLS published within the last 10 years, from 1 January 2015 through 23 September 2025, from four electronic databases (Embase, PubMed, SPORTDiscus, Cochrane Library) focusing on diagnosis, management, imaging, and criteria for return-to-sport. AREAS OF AGREEMENT: LLS is mainly described in male, skeletally immature overhead athletes aged 11-15. Early specialization, multi-team participation, and inadequate rest are reported risk factors. LLS commonly presents with throwing-related shoulder pain, proximal humeral physis tenderness, posterior capsule tightness, and scapular dyskinesia. X-rays remain first-line imaging, demonstrating lateral physeal widening and irregularity. Throwing cessation for 2-4 months, followed by rehabilitation and gradual return-to-throwing yields excellent short-term outcomes, with low rates of growth disturbance. Prevention strategies include pitch-counts, rest, proper throwing mechanics, and delayed specialization. AREAS OF CONTROVERSY: The prevalence of LLS remains unknown due to variable diagnostic criteria, imaging use, and underreporting. Recurrence and long-term sequelae are inconsistent across studies, and the reasons athletes discontinue baseball remain uncertain. Evidence is conflicting regarding the benefits of formal rehabilitation compared with rest alone. GROWING POINTS: Advanced imaging demonstrates structural remodeling of the shoulder, suggesting that repetitive loading during skeletal immaturity impacts long-term morphology and mechanics. AREAS TIMELY FOR DEVELOPING RESEARCH: Prospective studies using clinical and imaging criteria may help define the incidence, severity, risk factors, sport-specific patterns, and to clarify symptom resolution, humeral remodeling, and factors influencing attrition. Longitudinal studies should compare rest versus structured rehabilitation and varying return-to-throwing protocols.