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Ulnar collateral ligament

H Mike Kim, Colin R Andrews, Evan P Roush, Gregory I Pace, Gregory S Lewis
BACKGROUND: Double-strand lateral ulnar collateral ligament (LUCL) reconstruction is an effective treatment for posterolateral rotatory instability (PLRI) of the elbow, but anatomic landmarks for ulnar tunnel placement are often difficult to identify intraoperatively, which potentially can result in a nonanatomic LUCL reconstruction. This study investigated the effect of ulnar tunnel location on joint stability in double-strand LUCL reconstruction. METHODS: PLRI was artificially created in 7 cadaveric elbows, and double-strand LUCL reconstruction was performed...
October 10, 2016: Journal of Shoulder and Elbow Surgery
Christine C Johnson, Grant H Garcia, Joseph N Liu, Jeffrey G Stepan, Ronak M Patel, Joshua S Dines
BACKGROUND: The quality of medical information on the Internet has come under scrutiny. This study investigates the quality, accuracy, and readability of online information regarding ulnar collateral ligament (UCL) injuries. METHODS: Three search terms ("elbow ulnar collateral ligament injury," "tommy john injury," and "pitcher's elbow") were entered into 3 Internet search engines. Three independent reviewers evaluated the content and accuracy of the information with a set of predetermined scoring criteria...
October 10, 2016: Journal of Shoulder and Elbow Surgery
Udit Rawat, Jennifer L Pierce, Scott Evans, A Bobby Chhabra, Nicholas C Nacey
Despite having many unique anatomic features relative to the other digits, the thumb has received little attention in the radiology literature. The thumb, with its opposable and prehensile abilities, enables fine manual dexterity. However, most radiologists have little familiarity with the structures that allow these dynamic movements, other than their recognition of the role of the ulnar collateral ligament in the setting of gamekeeper injury. High-resolution magnetic resonance (MR) imaging allows optimal assessment of the intricate soft-tissue anatomy of the thumb, which enables thumb flexion, extension, abduction, and adduction...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Thomas Christensen, Shumaila Sarfani, Alexander Y Shin, Sanjeev Kakar
Background: The purpose of this study is to evaluate long-term outcomes of ligamentous repair rather than reconstruction for chronic thumb ulnar collateral ligament (UCL) injuries. Methods: Patients at least 15-years status-post repair of a chronic (greater than 6 weeks) UCL tear were contacted for clinical evaluation, radiographs, and postoperative outcome questionnaires, including the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, visual analog scale (VAS) pain scale, and study-specific questions...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
Mandhkani Mahajan, Christine Tolman, B Würth, Steven J Rhemrev
INTRODUCTION: A skiers thumb, or a partial or complete rupture of the ulnar collateral ligament (UCL) is a clinical diagnosis. Swelling, pain, natural left-right difference and inexperience of a young physician can cause difficulty to correctly diagnose this injury. However, our theory is that any physician, given the correct instructions, should be able to diagnose this injury solely on clinical findings, without the necessity of additional imaging. MATERIAL AND METHODS: In a large Dutch teaching hospital, physicians (residents with working experience of 6months-3years) working at the ER received instructions for physical examination...
October 2016: European Journal of Radiology
B M Saltzman, B J Erickson, J M Frank, J D Harris, G P Nicholson, B R Bach, N N Verma, A A Romeo
PURPOSE: The purpose was to perform a systematic review of the literature investigating biomechanical studies of ulnar collateral ligament reconstruction (UCLR) techniques to summarize the most commonly analyzed methods of fixation (at both the ulna and humerus), the degree of elbow flexion at the time of fixation, graft characteristics, and modes of failure with these techniques. MATERIALS AND METHODS: A systematic review was performed. All cadaveric biomechanical studies that tested a reconstruction method for UCLR were included...
September 14, 2016: Musculoskeletal Surgery
M Hackl, T Leschinger, L P Müller, K Wegmann
BACKGROUND: Chronic ligamentous instability of the elbow is an important pathology as it is accompanied with pronounced dysfunction. Moreover, it represents an established risk factor for the development of osteoarthritis. Posterolateral rotatory instability (PLRI) caused by insufficiency of the lateral collateral ligament (LCL) is the most common type of chronic elbow instability and is usually a sequel of traumatic elbow dislocation. Chronic overload can lead to insufficiency of the ulnar collateral ligament (UCL) with subsequent valgus instability, especially in overhead athletes...
October 2016: Der Orthopäde
M Hackl, T Leschinger, C Ries, W F Neiss, L P Müller, K Wegmann
BACKGROUND: Chronic posterolateral rotatory instability (PLRI) of the elbow is the result of an insufficiency of the lateral collateral ligament (LCL). Lateral ulnar collateral ligament (LUCL) reconstruction represents a well-established treatment method for PLRI. However, recurrent instability remains a problem. OBJECTIVES: The goal of this in-vitro study was to evaluate the posterolateral rotatory stability of the intact elbow, after sectioning of the LCL and after LUCL reconstruction with a triceps tendon autograft and double BicepsButton(TM) fixation...
October 2016: Der Orthopäde
Casey J Meyer, J Craig Garrison, John E Conway
BACKGROUND: Previous work has suggested that an increase in the amount of developmentally acquired, dominant arm humeral retrotorsion (D HRT) in the thrower's shoulder may be a potentially protective mechanism. Although the relationship between HRT and shoulder injuries has been reported, the relationship between HRT and ulnar collateral ligament (UCL) tears in baseball players is not known. PURPOSE: To determine whether D HRT and nondominant arm HRT (ND HRT) measurements in baseball players with a UCL tear differ statistically from a matched healthy cohort...
September 2, 2016: American Journal of Sports Medicine
Alfred Atanda, Lauren W Averill, Maegen Wallace, Tim A Niiler, Levon N Nazarian, Michael G Ciccotti
BACKGROUND: Stress ultrasound (SUS) of the elbow has demonstrated changes in the anterior band of the ulnar collateral ligament (UCL) in professional and high school-aged pitchers. However, there have been no large reports correlating pitching history data with SUS changes in youth and adolescent baseball pitchers. HYPOTHESIS: Changes of the UCL on SUS will correlate with pitching volume in youth and adolescent baseball pitchers. STUDY DESIGN: Cross-sectional study; Level of evidence, 3...
September 1, 2016: American Journal of Sports Medicine
Brian C Werner, Nicole S Belkin, Steve Kennelly, Leigh Weiss, Ronnie P Barnes, Scott A Rodeo, Russell F Warren, Robert N Hotchkiss
BACKGROUND: Thumb collateral ligament injuries occur frequently in the National Football League (NFL). In the general population or in recreational athletes, pure metacarpophalangeal (MCP) abduction or adduction mechanisms yield isolated ulnar collateral ligament (UCL) and radial collateral ligament (RCL) tears, respectively, while NFL athletes may sustain combined mechanism injury patterns. PURPOSE: To evaluate the incidence of simultaneous combined thumb UCL and RCL tears among all thumb MCP collateral ligament injuries in NFL athletes on a single team...
August 26, 2016: American Journal of Sports Medicine
Joshua S Dines, Phillip N Williams, Neal ElAttrache, Stan Conte, Todd Tomczyk, Daryl C Osbahr, David M Dines, James Bradley, Christopher S Ahmad
We conducted a study to evaluate the effect of platelet-rich plasma (PRP) injections on partial ulnar collateral ligament (UCL) tears in high-level throwing athletes. We retrospectively reviewed the cases of 44 baseball players (6 professional, 14 college, 24 high school) treated with PRP injections for partial-thickness UCL tears. All tears were diagnosed by physical examination and confirmed by magnetic resonance imaging (MRI). Sixteen patients had 1 injection, 6 had 2, and 22 had 3. Once patients became asymptomatic after injection, they were started on an interval throwing program...
July 2016: American Journal of Orthopedics
Ryan A Mlynarek, Andrew W Kuhn, Asheesh Bedi
The use of platelet-rich plasma (PRP) injections in the treatment of musculoskeletal conditions has become more prevalent in recent years. Current literature has exhibited that PRP injections are relatively safe and can potentially accelerate or augment the soft tissue healing process. This review presents the most current literature update on the use of PRP in the treatment of rotator cuff tears, osteoarthritis of the knee, ulnar collateral ligament tears, lateral epicondylitis, hamstring injuries, and Achilles tendinopathy...
July 2016: American Journal of Orthopedics
M Mickevičius, S Rutkauskas, S Sipavičienė, A Skurvydas, J Jürimäe, H Degens, S Kamandulis
The aim of this study was to assess whether side-to-side differences in morphology and function of the upper limbs in 11-12 year-old male baseball players with throwing-related pain (n=14) were more pronounced than that of age-matched healthy untrained subjects (n=16). Baseball players 1) had played baseball≥4.5 h·wk(-1) for ≥ 4 years and (2) suffered from moderate-intensity (3-6 points on 10-point questionnaire scale) throwing-related pain in the shoulder or elbow in at least 2 training sessions within the past month...
August 23, 2016: International Journal of Sports Medicine
Edward Lyle Cain, Owen McGonigle
Ulnar collateral ligament injury in the overhead athlete typically presents as activity-related pain with loss of velocity and control. Treatment options range from nonoperative rehabilitation to ligament reconstruction. Surgical reconstruction is frequently required to allow the athlete to return to competition and many surgical techniques have been described. The rehabilitation process to return back to overhead athletics, in particular pitching, is prolonged and requires progression through multiple phases...
October 2016: Clinics in Sports Medicine
Donald von Borstel, Michael Wang, Kirstin Small, Taiki Nozaki, Hiroshi Yoshioka
This study is intended as a review of 3Tesla (T) magnetic resonance (MR) imaging of the triangular fibrocartilage complex (TFCC). The recent advances in MR imaging, which includes high field strength magnets, multi-channel coils, and isotropic 3-dimensional (3D) sequences have enabled the visualization of precise TFCC anatomy with high spatial and contrast resolution. In addition to the routine wrist protocol, there are specific techniques used to optimize 3T imaging of the wrist; including driven equilibrium sequence (DRIVE), parallel imaging, and 3D imaging...
August 16, 2016: Magnetic Resonance in Medical Sciences: MRMS
Rachel Patrick, Josh McGinty, Ann Lucado, Beth Collier
BACKGROUND: Ulnar collateral ligament (UCL) tears and associated Tommy Johns surgical intervention from excessive and poor quality pitching has increased immensely-with more college and professional pitchers undergoing the surgery in 2014 alone than in the 1990s as a whole.(1) Faulty mechanics developed at young ages are often well-engrained by the late adolescent years and the minimal healing ability of the largely avascular UCL often leads to delayed safe return to sport.(2). PURPOSE: The purpose of this case study was to describe an innovative, multimodal approach to conservative management of a chronic UCL injury in a college-aged baseball pitcher...
August 2016: International Journal of Sports Physical Therapy
Patrick W Joyner, Jeremy Bruce, Ryan Hess, Arron Mates, Frederic Baker Mills, James R Andrews
BACKGROUND: 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. METHODS: 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...
October 2016: Journal of Shoulder and Elbow Surgery
Lucas Wymore, Paul Chin, Christopher Geary, Gregory Carolan, Daniel Keefe, Heinz Hoenecke, Jan Fronek
BACKGROUND: Ulnar collateral ligament (UCL) reconstruction (UCLR) has been studied and shown to be a successful procedure for returning overhead athletes to sport. Many studies of Major League Baseball (MLB) players have shown high levels of return to play with successful statistical performance. No study has followed professional advancement of drafted pitchers who underwent UCLR as amateurs when compared with drafted pitchers who did not undergo the procedure before selection in the MLB draft...
August 12, 2016: American Journal of Sports Medicine
Jeong Woo Kim, Young Yi, Tae Kyun Kim, Hong Je Kang, Jong Yun Kim, Jong Myoung Lee, Kyu Hwan Bae, Min Su Joo
BACKGROUND: Lateral ulnar collateral ligament injury following unstable elbow dislocation can induce posterolateral rotatory instability that requires surgery. The aim of this study was to determine the effectiveness of arthroscopic repair of the lateral collateral ligament (LCL) complex in an unstable elbow joint. METHODS: The study group consisted of 13 patients who experienced posterolateral rotatory instability after an unstable elbow dislocation with an injury to the lateral ulnar collateral ligament...
August 3, 2016: Journal of Bone and Joint Surgery. American Volume
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