Medial elbow pain in the throwing athlete can result from a variety of sources, including medial epicondylitis, valgus extension overload, ulnar collateral ligament (UCL) insufficiency, ulnar neuritis, and others.
Initial treatment following a UCL tear involves a period of rest (no throwing or strenuous use of the elbow) followed by rehabilitation and a graduated throwing program.
UCL reconstruction (UCLR) has become the preferred surgical treatment method for patients with a symptomatic, deficient UCL who wish to return to sports.
Several modifications to the original technique described by Jobe et al. have been proposed, including a muscle-splitting approach, a docking technique, and the use of various grafts, including hamstring autograft and several types of allografts.
The timing of return to sport following UCLR varies from patient to patient, with some patients being able to return within 12 months and others taking >18 months. Although the literature varies, typically >80% of patients are able to return to the same level of sport following UCLR.
1Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois
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