Best Practice Case Studies-Elbow Ulnar Collateral Ligament Injuries

Pdf Summary

Ulnar collateral ligament (UCL) injuries are a significant concern for baseball players, particularly pitchers, due to the high levels of stress placed on the medial elbow during the throwing motion. The incidence of these injuries has been rising, especially among adolescent players, with identified risk factors including pitch velocity, the interval between pitching sessions, and overall workload.<br /><br />Treatment of UCL injuries varies based on the severity of the tear. Grade I or II partial tears often respond well to nonoperative management, which includes a period of rest followed by a gradual return to throwing activities. Platelet-rich plasma (PRP) has emerged as a treatment option, although comprehensive clinical evidence is still needed. Most athletes can return to competitive throwing within 3 to 4 months after such conservative treatment.<br /><br />Surgery is generally reserved for complete (type III) UCL tears or when conservative management of a partial tear fails. UCL reconstruction is the widely accepted surgical option, with the modified Jobe and docking techniques achieving high success rates, with return-to-play rates between 80% and 90%. An emerging surgical option involves UCL repair with collagen-dipped suture tape augmentation, though long-term data, particularly among elite athletes, is lacking.<br /><br />The timeframe for returning to full competitive play post-reconstruction varies, commonly taking 12 to 15 months, though professional pitchers might require 15 to 18 months to regain former performance levels. Despite low revision rates (1%-7%), there's an anticipation of increased revisions as the number of initial UCL reconstructions rises.<br /><br />This summary is based on the collective medical expertise and clinical research of Dr. James B. Carr II, Dr. Christopher L. Camp, and Dr. Joshua S. Dines as detailed in their published work in the Arthroscopy journal.

Meta Tag

Edition 3rd Edition

Related Case 3rd Edition, CASE 15

Topic Elbow and Forearm

Keywords

3rd Edition, CASE 15

3rd Edition

Elbow and Forearm

Ulnar collateral ligament

UCL injuries

baseball pitchers

medial elbow stress

adolescent players

nonoperative management

platelet-rich plasma

UCL reconstruction

suture tape augmentation

return-to-play rates