Primary Repair of Ulnar Collateral Ligament Injuries of the Elbow in Young Athletes

Savoie, Felix H.; Trenhaile, Scott W.; Roberts, John M.; Field, Larry D.; Ramsey, J. Randall

doi:10.1177/0363546508315201

Cited by 173 publications

(80 citation statements)

References 29 publications

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“…In the largest and most recent individual series, Savoie and co-investigators reported that 56/60 (93%) of players returned to the same or higher level of sport mostly within 6 months with 93% of patients achieving an excellent or good result according to the Andrews-Carson score [67]. There were six complications, two of which required return to the operating room all occurring in athletes who were able to return to sport.…”

Section: Discussionmentioning

confidence: 98%

“…This procedure is currently indicated in young athletes with symptomatic instability of the elbow who have failed a course of non-operative management and have physical exam findings and radiographic evidence (stress X-rays and MR arthrogram) of valgus instability of the elbow due to MUCL deficiency [67]. Results have not been reported on professional athletes in recent series.…”

Section: Indications For Surgerymentioning

confidence: 99%

“…Currently, this technique is recommended in players who demonstrate rupture of the ligament from the proximal or distal attachment or both but is contraindicated in players with broad ligament damage. Proponents of this technique report that they still perform over twice as many reconstructions as they do repairs for MUCL deficiency reflective of the population that fulfills the above-stated criteria [67].…”

Section: Indications For Surgerymentioning

confidence: 99%

“…In cases in which arthroscopy is indicated prior to ligament repair, the patient is placed prone and the arm is then placed in an internally rotated position parallel to the trunk to access the medial elbow [67]. A 5-mm curvilinear incision beginning at the medial epicondyle and passing distally is then made.…”

Section: Repair Techniquesmentioning

confidence: 99%

“…Despite its excellent track record for return to sport, MUCL reconstruction has some significant drawbacks including morbidity associated with graft harvesting, prolonged postoperative rehabilitation program often lasting more than a year, and most recently, a rising failure rate requiring revision [66]. Recently, several investigators have revisited the issue of attempted MUCL repair in younger athletes with the premise that these players often have less damage to their ligament than older athletes and may be good candidates for repair rather than reconstruction [67]. This section will explore the current state of MUCL repair including indications, technique, early results, and future direction of this promising technique.…”

Section: Introductionmentioning

confidence: 99%

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Elbow Injuries in the Adolescent Thrower

Griffith

Kercher

Willimon

et al. 2018

Curr Rev Musculoskelet Med

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Purpose of Review With an increasing rate of adolescent elbow injuries, especially in throwing athletes, the purpose of this review is to investigate the current literature regarding the diagnosis, treatment, and non-operative and operative outcomes of medial epicondyle fractures, ulnar collateral ligament repair, osteochondritis dissecans of the elbow, and olecranon stress fractures. Recent Findings Acceptable outcomes with both non-operative and operative treatments of medial epicondyle fractures have been reported, with surgical indications continuing to evolve. Unstable osteochondritis dissecans lesions, especially in patients with closed growth plates, require operative fixation, and emerging open and arthroscopic techniques including lesion debridement, marrow stimulation, autograft transfer, and allograft transplantation are described with good outcomes. Ulnar collateral repair has emerged as an exciting treatment option for an avulsion of either end of the ligament in young throwing athletes, with faster rehabilitation times than traditional ulnar collateral ligament reconstruction. Olecranon stress fractures are increasing in prevalence, and when a non-operative treatment course is unsuccessful, athletes have a high return-to-play rate after percutaneous cannulated screw placement. Summary With proper indications, non-operative and operative treatment modalities are reported with a high return-to-play and acceptable clinical outcomes for common elbow injuries, including medial epicondyle fractures, ulnar collateral ligament repair, osteochondritis dissecans of the elbow, and olecranon stress fractures, in adolescent throwing athletes. Further research is needed to better define treatment algorithms, surgical indications, and outcomes.

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Section: Discussionmentioning

confidence: 98%

Section: Indications For Surgerymentioning

confidence: 99%

Section: Indications For Surgerymentioning

confidence: 99%

Section: Repair Techniquesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Elbow Injuries in the Adolescent Thrower

Griffith

Kercher

Willimon

et al. 2018

Curr Rev Musculoskelet Med

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Ulnar Collateral Ligament Injury

Eygendaal

Kaas

2011

Evidence‐Based Orthopedics

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Medial elbow anatomy: A paradigm shift for UCL injury prevention and management

et al. 2019

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To improve the management outcomes and diagnostic accuracy of the ulnar collateral ligament (UCL) injury, the anatomy of the medial side of the elbow joint is necessary to be understood in terms of the periarticular surroundings rather than the specific ligaments. The aim of this study was to anatomically clarify the medial side of the elbow joint in terms of the tendinous structures and joint capsule. We conducted a descriptive anatomical study of 23 embalmed cadaveric elbows. We macroscopically analyzed the relationship between the flexor pronator muscles (FPMs) and the joint capsule in 10 elbows, histologically analyzed in 6 elbows, and observed the bone morphology through micro computed tomography in 7 elbows. The two tendinous septa (TS) were found: between the pronator teres (PT) and flexor digitorum superficial (FDS) muscles, and between the FDS and flexor carpi ulnaris (FCU) muscles. These two TS are connected to the medial part of the brachialis tendon, deep aponeurosis of the FDS, and FCU to form the tendinous complex, which linked the humeroulnar joint and could not be histologically separated from each other. Moreover, the capsule of the humeroulnar joint under the tendinous complex had attachment on the ST of 7 mm width. The two TS, the brachialis tendon, the deep FDS and FCU aponeuroses, and the joint capsule linked the humeroulnar joint. These anatomical findings could lead to a paradigm shift in the prevention, diagnosis, and treatment of UCL injuries in baseball players. Clin. Anat. 32:379–389, 2019. © 2018 The Authors. Clinical Anatomy published by Wiley Periodicals, Inc. on behalf of American Association of Clinical Anatomists.

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Primary Repair of Ulnar Collateral Ligament Injuries of the Elbow in Young Athletes

Cited by 173 publications

References 29 publications

Elbow Injuries in the Adolescent Thrower

Elbow Injuries in the Adolescent Thrower

Ulnar Collateral Ligament Injury

Medial elbow anatomy: A paradigm shift for UCL injury prevention and management

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