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.