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Elbow Ulnar Collateral Ligament Injury

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1. The lateral collateral ligament complex of the elbow: quantitative anatomic analysis of the lateral ulnar collateral, radial collateral, and annular ligaments. (PubMed)

The lateral collateral ligament complex of the elbow: quantitative anatomic analysis of the lateral ulnar collateral, radial collateral, and annular ligaments. Injury to the lateral ulnar collateral ligament (LUCL) complex of the elbow often results in posterolateral rotatory instability. Although surgical reconstruction of the LUCL is often required, gaps in our understanding of the LUCL complex remain. The purpose of this study was to provide a robust and accurate characterization (...) of the lateral elbow ligamentous complex.The LUCLs, radial collateral ligaments, and annular ligaments in 10 cadaveric elbows were 3-dimensionally digitized and reconstructed using computed tomography. Surface areas, origin and insertion footprint areas, distances between perceived footprint centers and geometric footprint centroids, distances to key landmarks, and ligament isometry were measured.The mean surface area of the LUCL was 229.3 mm2. The mean origin and insertion footprint areas were 26.0 mm2

2018 Journal of Shoulder and Elbow Surgery

2. Return to Play and In-Game Performance Statistics Among Pitchers After Ulnar Collateral Ligament Reconstruction of the Elbow: A Systematic Review

Return to Play and In-Game Performance Statistics Among Pitchers After Ulnar Collateral Ligament Reconstruction of the Elbow: A Systematic Review Injury to the ulnar collateral ligament of the elbow is relatively common among baseball pitchers. Ulnar collateral ligament reconstruction (UCLR) has revolutionized the management of this injury, allowing a greater proportion of pitchers to return to play.To assess the return to play and in-game performance specific to baseball pitchers who have

2018 EvidenceUpdates

3. Nonreconstruction Options for Treating Medial Ulnar Collateral Ligament Injuries of the Elbow in Overhead Athletes (PubMed)

Nonreconstruction Options for Treating Medial Ulnar Collateral Ligament Injuries of the Elbow in Overhead Athletes This review aims to describe the nonreconstructive options for treating ulnar collateral ligament (UCL) injuries ranging from nonoperative measures, including physical therapy and biologic injections, to ligament repair with and without augmentation.Nonoperative options for UCL injuries include guided physical therapy and biologic augmentation with platelet-rich plasma (PRP (...) ). In some patients, repair of the UCL has shown promising return to sport rates by using modern suture and suture anchor techniques. Proximal avulsion injuries have shown the best results after repair. Currently, there is growing interest in augmentation of UCL repair with an internal brace. The treatment of UCL injuries involves complex decision making. UCL reconstruction remains the gold standard for attritional injuries and complete tears, which occur commonly in professional athletes. However

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2018 Current reviews in musculoskeletal medicine

4. Return to Play After PRP and Rehabilitation of 3 Elite Ice Hockey Players With Ulnar Collateral Ligament Injuries of the Elbow (PubMed)

Return to Play After PRP and Rehabilitation of 3 Elite Ice Hockey Players With Ulnar Collateral Ligament Injuries of the Elbow Ulnar collateral ligament (UCL) injury is a well-described etiology of pain and decreased performance for the overhead athlete. Despite a growing volume of literature regarding the treatment of these injuries for overhead athletes, there is a paucity of such data regarding stickhandling collision sport athletes, such as ice hockey players.The purpose of this study (...) of the elbow for all athletes, without tenderness to palpation over the UCL, including no tenderness over the humeral insertion site. Stability examination improved as well, demonstrating a soft to moderate endpoint with valgus stress, although this was not symmetric to the contralateral side. All athletes were able to continue to play at the same level of competition as before the injury occurred, without any complaints. No players had repeat injury during the same or following seasons.The authors present

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2018 Orthopaedic journal of sports medicine

5. Ulnar collateral ligament injuries of the elbow in female division I collegiate gymnasts: a report of five cases (PubMed)

Ulnar collateral ligament injuries of the elbow in female division I collegiate gymnasts: a report of five cases Elbow ulnar collateral ligament (UCL) injuries in gymnastics have not been well documented in the literature, in comparison to UCL injuries in baseball. Few studies have examined the mechanism and nonoperative management of this injury, and no studies to date have been published on incidence of injury and return to play recommendations in gymnastics.A literature search was performed (...) using PubMed to review articles from 1980 to 2016 that addressed the biomechanics of UCL injury in baseball and gymnastics, the anatomy of the elbow, injury rates, surgical vs non-surgical management, rehabilitation, and return to play recommendations for the sport of gymnastics. Five female collegiate gymnasts sustained UCL injury over a 3-year period. Electronic medical records for each case were thoroughly reviewed including imaging, surgical and non-surgical management, rehabilitation

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2018 Open access journal of sports medicine

6. Radiographic comparison of adolescent athletes with elbow osteochondritis dissecans to ulnar collateral ligament injuries and controls. (PubMed)

Radiographic comparison of adolescent athletes with elbow osteochondritis dissecans to ulnar collateral ligament injuries and controls. There are excellent data supporting recommendations to prevent elbow injuries (osteochondritis dissecans [OCD] and ulnar collateral ligament [UCL] injuries), such as pitch count and pitch type in baseball, but anatomic risk factors have not been thoroughly examined. This study aimed to evaluate radiographic measurements in adolescents with elbow OCD lesions (...) or UCL injuries and controls.We retrospectively identified adolescent patients between 2011 and 2016 with isolated capitellum OCD, UCL tear, or normal elbows based on magnetic resonance imaging. Nineteen patients (mean age, 13.5 years) had isolated OCD defects of the capitellum, 8 patients (mean age, 16.9 years) had isolated UCL complete tear, and the remaining 16 patients (mean age, 14.6 years) were normal controls. Radiographic measurements from corresponding anterior-posterior elbow radiographs

2017 Journal of Shoulder and Elbow Surgery

7. Management of ulnar collateral ligament injury in throwing athletes: a survey of the American Shoulder and Elbow Surgeons. (PubMed)

Management of ulnar collateral ligament injury in throwing athletes: a survey of the American Shoulder and Elbow Surgeons. Amid evidence that the number of ulnar collateral ligament (UCL) reconstructions performed annually is on the rise, there continues to be significant variation among surgeons in the management of UCL injuries. The purpose of this paper was to survey the members of the American Shoulder and Elbow Surgeons (ASES) to assess current trends related to the comprehensive treatment (...) and well-trained cohort of surgeons tended to agree and often reached consensus opinions on how to approach UCL injury. Professional athletes and those with complete tears were indicated for surgery by consensus, whereas opinion was more divided on how to treat partial tears or nonprofessionals.Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

2017 Journal of Shoulder and Elbow Surgery

8. Trends in Sports-Related Elbow Ulnar Collateral Ligament Injuries (PubMed)

Trends in Sports-Related Elbow Ulnar Collateral Ligament Injuries Elbow ulnar collateral ligament (UCL) injuries are common, particularly in adolescent athletes playing overhead sports. While the incidence and outcomes of surgical UCL injuries are well documented, the nonsurgical UCL injury patterns and injury management in this population are not yet known.The purpose of this study was to retrospectively assess the injury severity and subsequent management of UCL injuries among competitive (...) . Patients were stratified into 3 age brackets (age 11-13 years, n = 17; age 14-16 years, n = 49; age 17-22 years, n = 70). There were no prior elbow surgical interventions. The main outcome measures included the frequency and severity of UCL injuries and injury management (surgical, nonsurgical). Independent variables included age, UCL injuries per year, and sport classification.There were 53 surgical and 83 nonsurgical UCL injuries. The number of nonsurgical cases increased 9-fold from 2000-2008

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2017 Orthopaedic journal of sports medicine

9. Nonoperative Treatment of Elbow Ulnar Collateral Ligament Injuries With and Without Platelet-Rich Plasma in Professional Baseball Players: A Comparative and Matched Cohort Analysis. (PubMed)

Nonoperative Treatment of Elbow Ulnar Collateral Ligament Injuries With and Without Platelet-Rich Plasma in Professional Baseball Players: A Comparative and Matched Cohort Analysis. Recent studies evaluating nonoperative treatment of elbow ulnar collateral ligament (UCL) injuries augmented with platelet-rich plasma (PRP) have shown promising results. To date, no comparative studies have been performed on professional baseball players who have undergone nonoperative treatment with or without PRP (...) injections for UCL injuries.Players who received PRP injections would have better outcomes than those who did not receive PRP.Cohort study; Level of evidence, 3.The Major League Baseball (MLB) Health and Injury Tracking System identified 544 professional baseball players who were treated nonoperatively for elbow UCL injuries between 2011 and 2015. Of these, 133 received PRP injections (PRP group) before starting their nonoperative treatment program, and 411 did not (no-PRP group). Player outcomes

2019 American Journal of Sports Medicine

10. Incidence of Elbow Ulnar Collateral Ligament Surgery in Collegiate Baseball Players (PubMed)

Incidence of Elbow Ulnar Collateral Ligament Surgery in Collegiate Baseball Players Recent reports have highlighted the progressive increase in the incidence of ulnar collateral ligament (UCL) injuries to the elbow in baseball players of all levels. However, knowledge of the incidence and other epidemiological factors regarding UCL injuries, specifically in college baseball players, is currently lacking.To evaluate, over a period of 1 year, the incidence of UCL injuries requiring surgery (...) -seasons vs 2.1/100 player-seasons, respectively). Nearly half of surgeries (48.5%) were performed during the baseball season.The incidence of UCL surgeries in NCAA Division I collegiate baseball players represents substantial morbidity to this young athletic population. Risk factors for injuries requiring surgery include being a pitcher and an underclassman. Awareness of these factors should be considered in injury prevention programs. Furthermore, this initial study can serve as a foundation

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2018 Orthopaedic journal of sports medicine

11. Biomechanical analysis of elbow medial ulnar collateral ligament tear location and its effect on rotational stability. (PubMed)

Biomechanical analysis of elbow medial ulnar collateral ligament tear location and its effect on rotational stability. Recent anatomic and clinical studies have shown that the location of the injury to the elbow ulnar collateral ligament (UCL) is an important variable in deciding on surgical intervention; however, no studies have evaluated these findings biomechanically.This study tested 16 intact elbow specimens. Valgus torques of 2.5 and 5 Nm were applied to the elbow at various flexion (...) angles, and the resulting valgus angles were measured. The valgus angles were applied to the elbows in their intact states and again after partial and complete cuts were made on the proximal and distal insertions of the UCL. Resulting valgus torques were measured, and stiffness was calculated for each elbow flexion angle. Unpaired t tests were used to evaluate the effects of cut location and flexion angle on joint rotational stability and stiffness.The posterior-distal insertion contributed the most

2018 Journal of Shoulder and Elbow Surgery

12. Glenohumeral rotation deficits in high school, college, and professional baseball pitchers with and without a medial ulnar collateral ligament injury. (PubMed)

Glenohumeral rotation deficits in high school, college, and professional baseball pitchers with and without a medial ulnar collateral ligament injury. It is unclear how a glenohumeral internal rotation (IR) loss (GIRLoss), a glenohumeral external rotation (ER) gain (GERGain), or a total rotational motion (TRM) deficit (TRMD) predict medial ulnar collateral ligament (MUCL) injury risk among high school (HS), college (COLL), and professional (PRO) baseball pitchers with and without MUCL injury (...) °, 48° ± 10°, respectively; P = .121), and TRM (162° ± 14°, 160° ± 15°, 161° ± 14°, respectively; P = .770).Greater GIRLoss, GERGain, and TRMD in MUCL injured pitchers compared with uninjured pitchers implies these variables may be related to increased MUCL injury risk, especially because GIRLoss >18° and TRMD >5° demonstrate an increased MUCL injury risk. Shoulder rotational motion and deficits do not vary among HS, COLL, and PRO levels of pitchers.Copyright © 2018 Journal of Shoulder and Elbow

2019 Journal of Shoulder and Elbow Surgery

13. Elbow ulnar collateral ligament injuries in athletes: Can we improve our outcomes? (PubMed)

Elbow ulnar collateral ligament injuries in athletes: Can we improve our outcomes? Injury to the ulnar collateral ligament (UCL) most commonly occurs in the overhead throwing athlete. Knowledge surrounding UCL injury pathomechanics continues to improve, leading to better preventative treatment strategies and rehabilitation programs. Conservative treatment strategies for partial injuries, improved operative techniques for reconstruction in complete tears, adjunctive treatments, as well (...) as structured sport specific rehabilitation programs including resistive exercises for the entire upper extremity kinetic chain are all important factors in allowing for a return to throwing in competitive environments. In this review, we explore each of these factors and provide recommendations based on the available literature to improve outcomes in UCL injuries in athletes.

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2016 World journal of orthopedics

14. Elbow Ulnar Collateral Ligament Injury

Elbow Ulnar Collateral Ligament Injury Elbow Ulnar Collateral Ligament Injury Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Elbow (...) Ulnar Collateral Ligament Injury Elbow Ulnar Collateral Ligament Injury Aka: Elbow Ulnar Collateral Ligament Injury , Ulnar Collateral Ligament Injury , Elbow UCL Injury , UCL Injury , Elbow Ulnar Collateral Ligament Sprain , Elbow MCL Injury , Elbow Medial Collateral Ligament Injury From Related Chapters II. Pathophysiology Injury typically occurs with overhead throwing (e.g. baseball, volleyball) III. Symptoms Pop heard and felt at the medial elbow with provocative activity (e.g. overhead throwing

2018 FP Notebook

15. Magnetic resonance imaging-based classification for ulnar collateral ligament injuries of the elbow. (PubMed)

Magnetic resonance imaging-based classification for ulnar collateral ligament injuries of the elbow. Magnetic resonance imaging (MRI) arthrography has been considered the gold standard for imaging ulnar collateral ligament (UCL) injuries. No classification system has been described for UCL tears to help discuss and guide treatment options. We propose that an MRI-based UCL classification system would correlate with valgus laxity and help predict surgical management.The MRIs from 240 patients who (...) underwent UCL reconstruction were reviewed and classified according to a system based on severity and location of the UCL injury. Bilateral elbow valgus stress radiographs were used to compare the amount of valgus laxity associated with each grade of UCL injury. Additional data from the imaging review included intraligamentous calcifications, T-sign presence, and a newly described "vacuum sign."The amount of valgus stress opening increased with the classification severity as follows: type I, 0.13 mm

2016 Journal of Shoulder and Elbow Surgery

16. Epidemiology of Elbow Ulnar Collateral Ligament Injuries Among Baseball Players: National Collegiate Athletic Association Injury Surveillance Program, 2009-2010 Through 2013-2014. (PubMed)

Epidemiology of Elbow Ulnar Collateral Ligament Injuries Among Baseball Players: National Collegiate Athletic Association Injury Surveillance Program, 2009-2010 Through 2013-2014. Injuries to the ulnar collateral ligament (UCL) of the elbow are of major concern in baseball; however, the epidemiology of these injuries among National Collegiate Athletic Association (NCAA) athletes is poorly described.To determine the incidence of UCL injuries in NCAA baseball and investigate the risk factors (...) involved.Descriptive epidemiology study.All UCL injuries for academic years 2009-2010 through 2013-2014 were extracted from the NCAA Injury Surveillance Program database. The incidence was calculated for different positions, activity, time in game, competition status, and injury characteristics and compared via injury risk ratios to determine risk factors for injury occurrence. The NCAA provides sampling weights based on division and year. For all other injury characteristic analysis, unweighted data were

2018 American Journal of Sports Medicine

17. Functional outcomes following lateral ulnar collateral ligament reconstruction for symptomatic posterolateral rotatory instability of the elbow in an athletic population. (PubMed)

Functional outcomes following lateral ulnar collateral ligament reconstruction for symptomatic posterolateral rotatory instability of the elbow in an athletic population. The purpose of this investigation was to characterize the functional and surgical outcomes following lateral ulnar collateral ligament (LUCL) reconstruction for posterolateral rotatory instability in an athletic population.All US military service members who underwent LUCL reconstruction between 2008 and 2013 were identified (...) Elbow Performance Score, and 96% of patients reported no significant disability by the QuickDASH disability evaluation. Postoperatively, 4 patients (17%) experienced complications, with 3 (13%) requiring reoperation.Although the diagnosis and surgical management of isolated LUCL injury are relatively infrequent, LUCL reconstruction for posterolateral rotatory instability offers a reliable return to preinjury level of function among active individuals with intense upper extremity demands. However

2017 Journal of Shoulder and Elbow Surgery

18. The success of return to sport after ulnar collateral ligament injury in baseball: a systematic review and meta-analysis. (PubMed)

The success of return to sport after ulnar collateral ligament injury in baseball: a systematic review and meta-analysis. Ulnar collateral ligament injury (UCLI) has significantly increased in overhead sports during the past 2 decades. Differences in return to sport (RTS) and RTS at previous level (RTSP) after UCLI have not been differentiated.A computer-assisted literature search of PubMed, CINAHL, Embase, and SportDiscus databases using keywords related to RTS for UCLI was implemented (...) overall RTS proportion is higher than RTSP, regardless of treatment type for UCLI. Although RTS proportions remained consistent across various levels of play, RTSP proportions were lower in professional players, particularly Minor League Baseball compared with collegiate and high school players. Pitching performance significantly decreased postoperatively in most studies.Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

2018 Journal of Shoulder and Elbow Surgery

19. Risk factors for ulnar collateral ligament injury in professional and amateur baseball players: a systematic review with meta-analysis. (PubMed)

Risk factors for ulnar collateral ligament injury in professional and amateur baseball players: a systematic review with meta-analysis. Risk factors for ulnar collateral ligament injury (UCLI) are unclear despite increasing injury rates. We sought to summarize UCLI risk factors in baseball players.A computer-assisted search of 4 databases was performed using keywords related to UCLI risk factors. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used (...) humeral retrotorsion (in professional and amateur players) as well as pitching velocity (in professional players) demonstrated strong to moderate evidence as risk factors for UCLI. Dominant arm total arc of motion, external, or IR ROM were not risk factors for UCLI. Standardized collection and reporting of risk factors is recommended to more clearly elucidate definitive risk factors for UCLI.Copyright © 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights

2018 Journal of Shoulder and Elbow Surgery

20. Ulnar Nerve Complications After Ulnar Collateral Ligament Reconstruction of the Elbow: A Systematic Review. (PubMed)

Ulnar Nerve Complications After Ulnar Collateral Ligament Reconstruction of the Elbow: A Systematic Review. While ulnar collateral ligament reconstruction (UCLR) of the elbow is an increasingly commonly performed procedure with excellent results reported in the published literature, less attention has been paid to specifically on the characterization of postoperative ulnar nerve complications, and it is unclear what operative strategies may influence the likelihood of these complications.The (...) purpose of this study is to examine the prevalence and type of ulnar nerve complications after UCLR of the elbow based on the entirety of previously published outcomes in the English literature. In addition, this study examined how the rate of ulnar nerve complications varied as a function of surgical exposures, graft fixation techniques, and ulnar nerve management strategies.Systematic review and meta-analysis.A systematic review of the literature was completed using the MEDLINE, PubMed, and Ovid

2018 American Journal of Sports Medicine

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