Background: The ulnar collateral ligament (UCL) is the primary static stabilizer of the medial elbow between 30° and 130° of elbow flexion. Athletes participating in overhead throwing sports, such as baseball, have the highest rate of UCL injury. High-grade injuries often require surgical intervention.
Indications: Low-grade UCL injuries are typically treated nonoperatively; however, high-grade injuries can require surgical intervention for full healing and function to be achieved.
Technique description: A 5-cm incision is made from the medial epicondyle to the sublime tubercle to allow for dissection to the level of the flexor pronator fascia. Palpation is used to identify the sublime tubercle, the fascia is incised, and the flexor pronator musculature is split to reveal the underlying UCL. An ulnar anchor is placed, and the distal portion of the anterior bundle of the UCL is repaired with suture. Suture tapes were added around the suture, and a humeral anchor was placed. After all sutures were tied, the elbow was taken through the full range of motion to confirm that an isometric construct was successfully created.
Results: This patient achieved a full, pain-free range of motion and a rapid return to sports (RTS) postoperatively. Current data suggest that UCL repair with suture tape augmentation may be advantageous over UCL reconstruction, as it demonstrates higher RTS rates.
Discussion/conclusion: UCL repair with suture tape augmentation is a viable alternative to UCL reconstruction in younger patients with good ligament quality who have sustained a UCL avulsion. A fast RTS and favorable postoperative outcomes can be achieved after this procedure, enabling motivated athletes to return to their sport. In older patients with UCL injuries, UCL reconstruction or hybrid UCL reconstruction with suture tape augmentation should be considered as a treatment option.
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.
Keywords: orthopaedic surgery; ulnar collateral ligament; ulnar collateral ligament augmentation.
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