Medial Ulnar Collateral Ligament Injuries in Contact Athletes

Vaswani, Ravi; White, Alex E.; Dines, Joshua S.

doi:10.1007/s12178-022-09785-0

Cited by 3 publications

(6 citation statements)

References 36 publications

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“…It is well known that the MUCL of the elbow is the primary restraint to valgus force during the throwing motion. 1,8,9 The most common injury mechanism occurs through high repetitive loading during the late cocking and early acceleration phase of throwing. Patients commonly present with medial elbow pain and decreased throwing velocity, decreased control, and decreased throwing stamina.…”

Section: Video Transcriptmentioning

confidence: 99%

“…Patients commonly present with medial elbow pain and decreased throwing velocity, decreased control, and decreased throwing stamina. 1,9…”

Section: Video Transcriptmentioning

confidence: 99%

Section: Video Transcriptmentioning

confidence: 99%

“…Patients commonly present with medial elbow pain and decreased throwing velocity, decreased control, and decreased throwing stamina. 1,9 MUCL injuries continue to rise year over year, and this is particularly true in our younger athletes. While MUCL reconstruction remains the gold standard for many highlevel throwing athletes, MUCL repair has become a viable option in recent years.…”

Section: Surgical Techniquesmentioning

confidence: 99%

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Repair of the Medial Ulnar Collateral Ligament of the Elbow With Internal Brace Augmentation

Nauert

Camp

2023

Video Journal of Sports Medicine

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Background: The medial ulnar collateral ligament (MUCL) is the primary restraint to valgus force across the elbow during throwing. The incidence of MUCL continues to rise, and injuries are common in overhead throwing athletes often leading to elbow pain and instability. While MUCL reconstruction remains the gold standard for high-level throwing athletes with midsubstance tears, MUCL repair remains an option for select athletes and affords good functional outcomes with quicker return to sport compared with reconstruction. Indications: Indications for MUCL repair include acute injuries, proximal or distal avulsions, young and lower demand athletes, non-throwing athletes, or older athletes who may be nearing retirement. Technique Description: An incision is made over the medial elbow from the medial epicondyle to the sublime tubercle. Dissection is carried down to fascia which is split in line with its fibers. The flexor pronator muscle group is bluntly divided, and the ligament exposed. Care is taken to identify and dissect the native ligament. The avulsed portion of the ligament is secured with a 0 FiberWire suture in a running locked whipstitch fashion. The footprint of the avulsed ligament is gently debrided and prepared using a scalpel. The 0-FiberWire suture tails are then loaded onto a suture anchor preloaded with suture tape. This is then secured at the footprint of the ligament. The FiberWires are cut, and the suture tape is then pulled back over the native ligament and fixed at the other attachment site for the ligament. 0-Vicryl sutures are then used to suture the internal brace to the underlying ligament so the construct would move as a single unit. Results: Biomechanical testing has demonstrated that MUCL repair with internal brace augmentation has similar time-zero failure strength when compared with the original Jobe reconstruction technique while also having greater resistance to gapping. In addition, recent literature has shown that well-selected patients can have excellent functional outcomes and quicker return to sport with MUCL repair as opposed to reconstruction. Discussion: Medial ulnar collateral ligament repair with internal brace augmentation can be a successful treatment in the appropriately indicated athlete to allow for good functional results and quicker return to sport. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

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Section: Video Transcriptmentioning

confidence: 99%

“…Patients commonly present with medial elbow pain and decreased throwing velocity, decreased control, and decreased throwing stamina. 1,9…”

Section: Video Transcriptmentioning

confidence: 99%

Section: Video Transcriptmentioning

confidence: 99%

Section: Surgical Techniquesmentioning

confidence: 99%

See 2 more Smart Citations

Repair of the Medial Ulnar Collateral Ligament of the Elbow With Internal Brace Augmentation

Nauert

Camp

2023

Video Journal of Sports Medicine

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“…It is commonly injured in overhead throwing athletes when a valgus force is focused onto the elbow [15][16][17]. In non-overhead throwing athletes, cases have been reported where the mUCL sustains damage via a traumatic insult [18].…”

Section: Introductionmentioning

confidence: 99%

Traumatic Triceps and Medial Ulnar Collateral Ligament Rupture in an Adolescent Mogul Skier: A Case Report

Froom,

Wang,

Martin

et al. 2024

Cureus

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Triceps tendon ruptures are uncommon injuries that account for less than 1% of all upper extremity tendon injuries. Medial ulnar collateral ligament injury (mUCL), while common in overhead athletes as a result of valgus forces during the throwing mechanics, has scarcely been reported in non-overhead, throwing individuals. Traumatic assault to the elbow may result in the rupture of the triceps tendon with concomitant mUCL injury. As such an injury pattern typically presents in middle-aged males, weightlifters, or American football players from eccentric overloading of the elbow. We present an adolescent, elite-level, competitive skier with traumatic onset distal triceps rupture with concomitant medial ulnar collateral ligament rupture suffered via a fall on an outstretched hand (FOOSH) mechanism. Magnetic resonance imaging (MRI) showed acute full-thickness avulsion of the distal triceps tendon occurring at the olecranon enthesis. An open tendon repair was performed, and the patient was able to report significant symptom resolution over the course of six months postoperatively and successfully return to elite-level competition. This was a unique and rare case of triceps tendon rupture with concomitant mUCL injury in an adolescent via a non-contact, high-velocity injury mechanism. While a rare injury combination, this case nevertheless identifies an area of research not currently extensively covered-trampoline training and associated injuries in adolescents. This case, therefore, not only adds a novel dimension to the understanding of triceps and mUCL injuries in young athletes but also underscores the need for heightened awareness and specific safety protocols in sports training involving equipment like trampolines.

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Rehabilitation of an Upper Extremity Weight-Bearing Athlete with an Ulnar Collateral Ligament Injury: A Case Report

Corbitt,

Bandy

2024

International Journal of Sports Physical Therapy

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Background and Purpose Ulnar collateral ligament (UCL) injury is a common elbow injury among overhead athletes, particularly baseball pitchers. However, limited research exists for non-throwing athletes, especially regarding rehabilitation. The purpose of this case report is to illustrate the use of early weight-bearing activities into the rehabilitation protocol for non-operative management of athletes with a UCL injury. Case Description The subject was a 17-year-old female competitive cheerleader. Two weeks prior, during the performance of an acrobatic skill in which she transitioned to full upper extremity (UE) weight-bearing, she sustained an injury to her right elbow. Physical therapy examination findings indicated a diagnosis of a UCL sprain. Self-reported outcome measures revealed a FOTO score of 69/100 and a Quick Dash score of 43/100. The subject attended 14 therapy sessions over nine weeks to address physical function and performance, which were assessed at intervals during her therapy program. Rehabilitation consisted of therapeutic exercise for the progression of UE functional weight-bearing including planks, ball push-ups, handstands, crab walks, stool pulls, handstand walks, and UE plyometric jumps. Outcomes Along with documented improvement of the standard musculoskeletal examination measures of range of motion, strength, and functional performance, the subject demonstrated no elbow instability and improved FOTO and Quick Dash scores of 98 and 0, respectively. The subject demonstrated 105% limb symmetry index with the return to sport (RTS) UE functional testing of one-armed seated shot-put throw (SSPT) and achieved normative values with the closed kinetic chain upper extremity stability test (CKCUEST). Conclusion This case report highlights the successful treatment of a subject with a UCL injury and the integration of therapy interventions with a focus on UE weight-bearing. Further research on performing high level UE weight-bearing activities during rehabilitation and RTS guidelines is needed.

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Medial Ulnar Collateral Ligament Injuries in Contact Athletes

Cited by 3 publications

References 36 publications

Repair of the Medial Ulnar Collateral Ligament of the Elbow With Internal Brace Augmentation

Repair of the Medial Ulnar Collateral Ligament of the Elbow With Internal Brace Augmentation

Traumatic Triceps and Medial Ulnar Collateral Ligament Rupture in an Adolescent Mogul Skier: A Case Report

Rehabilitation of an Upper Extremity Weight-Bearing Athlete with an Ulnar Collateral Ligament Injury: A Case Report

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