Ulnar Collateral Ligament Injury
Pathology
Ulnar collateral ligament injury of the elbow is a sprain (tear) of one of the ligaments on the inner side of the elbow
MOI
two main mechanisms of injury
slow deterioration
acute rupture of the ligament
slow deterioration
acute rupture of the ligament
Signs and Symptoms
Pain
During the acceleration phase of throwing
Closing the hand and clenching the fist
Range of motion
Swelling
During the acceleration phase of throwing
Closing the hand and clenching the fist
Range of motion
Swelling
Structures Involved
UCL
thick band of tissue that forms a triangular shape along the inside of the elbow.
anterior bundle
posterior bundle
transverse ligaments
thick band of tissue that forms a triangular shape along the inside of the elbow.
anterior bundle
posterior bundle
transverse ligaments
Non Surgical Treatment
RICE
NSAIDS
Bicep curls
pronating and supinating the forearm
grip strengthening exercises
NSAIDS
Bicep curls
pronating and supinating the forearm
grip strengthening exercises
Corrective Technique
AT, along with coach, should analyze athlete’s throwing mechanics, which may include video assessment, to correct any existing faulty mechanics.
Surgical Treatment
Tommy John Surgery
Autograft of palmaris longus tendon
Holes drilled in medial epicondyle of the humerus
Autograft laced in epicondyle in figure eight shape
Autograft of palmaris longus tendon
Holes drilled in medial epicondyle of the humerus
Autograft laced in epicondyle in figure eight shape
Rehab
12-18 months
If not treated
Elbow dislocation
This can then lead to chronic pain and valgus instability
This can then lead to chronic pain and valgus instability
http://www.dukehealth.org/orthopaedics/services/elbow-and-hand/care-guides/tommy-john-surgery