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Review of UCL Elbow Injuries

Both men and women in overhead throwing sports are at risk for ulnar
collateral ligament (UCL) injuries of the elbow. Finding ways to return
them to their previous level of play is the subject of many studies.

This review article summarizes the information from recent articles on UCL
injuries. Anatomy, diagnosis, and treatment of this problem are presented. The goal of treatment is to restore stability to the elbow. It must be pain free and able to hold up under the stresses of repetitive, overhead throwing activities.

When conservative care is unable to restore elbow function, then surgery may
be needed. Twenty years ago, surgery was done to repair or reattach the torn ligament. Poor results from this treatment led to improved surgical methods.

Modifications to the operation included using a tendon graft to reconstruct
the ligament. Success improved but the results remained inferior. The athletes
were unable to get the same motion and strength that is possible with a
normal, uninjured ligament. Surgeons have continued to look for better ways to attach the graft.

The authors review the current methods of graft fixation. The docking
technique tucks the ends of the tendon graft into a tiny tunnel made in
the bone. Screw fixation is another popular method of securing the
tendon graft.

With any surgical method currently available, it can take up to a year or
longer for the athlete to get back to competitive sports. Finding treatment
strategies to allow earlier return to previous level of play is the goal of
future studies.

References: Jeffrey Guy, MD, et al. Ulnar Collateral Ligament Injuries of the Elbow. In Current Opinion in Orthopaedics. March 2007. Vol. 18. No. 2. Pp. 177-181.

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