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Ulnar collateral ligament

Christopher L Camp, Stan Conte, John D'Angelo, Stephen A Fealy, Christopher S Ahmad
BACKGROUND: In recent years, there has been a dramatic rise in the annual number of ulnar collateral ligament (UCL) reconstructions performed in amateur baseball pitchers. Accordingly, increasing numbers of players are entering professional baseball having already undergone the procedure; however, the effect of prior UCL reconstruction on future success remains unknown. PURPOSE: (1) To provide an epidemiologic report on baseball players who undergo UCL reconstruction before being selected in the Major League Baseball (MLB) Draft, (2) to define the outcomes in terms of statistical performance, and (3) to compare these results with those of matched controls (ie, non-UCL reconstruction)...
March 1, 2018: American Journal of Sports Medicine
Christopher Looze, Eric Strauss, Laith Jazrawi
Shoulder and elbow injuries have been described in baseball players as early as the 1940s. Ulnar collateral ligament (UCL) tears have been recognized as a significant source of disability for baseball players and have been seen in increasing frequency as training regimens and level of play have become more intense and rigorous. Our understanding and treatment of these injuries have also evolved over time. This article summarizes the evolution of the treatment of UCL tears and discusses future directions for the treatment and prevention of these injuries...
March 2018: Bulletin of the Hospital for Joint Diseases
Brett S Pexa, Eric D Ryan, Joseph B Myers
BACKGROUND: Previous research indicates that the amount of valgus torque placed on the elbow joint during overhead throwing is higher than the medial ulnar collateral ligament (UCL) can tolerate. Wrist and finger flexor muscle activity is hypothesized to make up for this difference, and in vitro studies that simulated activity of upper extremity musculature, specifically the flexor digitorum superficialis and flexor carpi ulnaris, support this hypothesis. PURPOSE: To assess the medial elbow joint space at rest, under valgus stress, and under valgus stress with finger and forearm flexor contraction by use of ultrasonography in vivo...
March 1, 2018: American Journal of Sports Medicine
Babak Shekarchi, Mohammadreza Mokhdanzadeh Dashti, Mostafa Shahrezaei, Ebrahim Karimi
Introduction: Timely diagnosis and treatment of traumatic injury to ulnar collateral ligament (UCL) of thumb is of special importance for preserving the full function of the hand. Therefore, the present study has been designed with the aim of evaluating the accuracy of ultrasonography in detection of these injuries. Methods: The present diagnostic accuracy study was performed on trauma patients over 15 years old who had clinical evidence of injury to UCL of thumb and were admitted to the emergency department...
2018: Emergency (Tehran, Iran)
Nathan E Marshall, Toufic R Jildeh, Kelechi R Okoroha, Fabien Meta, Vincent A Lizzio, Vasilios Moutzouros, Eric C Makhni
PURPOSE: The purpose of our study was to evaluate return to play and postinjury performance of professional catchers who sustained an ulnar collateral ligament (UCL) rupture requiring surgical reconstruction. We looked to evaluate these players to determine the rate of return to play, the level of return to play, and career longevity after surgery as well as how statistical performance is affected by reconstruction. METHODS: Twenty-five professional catchers who underwent UCL reconstruction between 1985 and 2015 were identified and compared with an age-, position-, and competition-matched control group...
February 23, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Kyle R Sochacki, Robert A Jack, Richard Nauert, Shari R Liberman, Patrick C McCulloch, David M Lintner, Joshua D Harris
BACKGROUND: Acute ruptures of the ulnar collateral ligament (UCL) of the thumb are common injuries in sports. Surgical repair of complete tears has yielded excellent results in elite athletes. METHODS: National Football League (NFL) players who underwent thumb UCL surgery and matched controls were identified. Demographic and performance data were collected. Performance scores were calculated using a standardized scoring system. Return to sport (RTS) in the NFL was defined as playing in at least 1 NFL game after thumb UCL surgery...
February 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
Ferdinando Draghi, Salvatore Gitto, Stefano Bianchi
Injuries to the collateral ligaments of the metacarpophalangeal (MCP) and interphalangeal (IP) joints are commonly encountered in both athletes and nonathletes. They require prompt evaluation to ensure proper management and prevent loss of joint motion and permanent disability. Imaging is often required to confirm the diagnosis and assess injury severity. This review article aims to provide physicians with guidelines for sonographic assessment of the collateral ligaments of the MCP and IP and related injuries...
February 26, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Christopher M Jones, David P Beason, Jeffrey R Dugas
Background: Ulnar collateral ligament (UCL) injuries have increased significantly in recent years, and reconstruction has become the preferred treatment for UCL injury over ligament repair. In a recent study, UCL repair with internal bracing demonstrated significantly greater resistance to gap formation in biomechanical tests, even at low cycles of valgus loading. Purpose/Hypothesis: The purpose of this study was to compare the fatigue and failure mechanics of traditional UCL reconstruction with UCL repair and internal bracing...
February 2018: Orthopaedic Journal of Sports Medicine
Timothy B Griffith, James Kercher, S Clifton Willimon, Crystal Perkins, Xavier A Duralde
PURPOSE OF REVIEW: With an increasing rate of adolescent elbow injuries, especially in throwing athletes, the purpose of this review is to investigate the current literature regarding the diagnosis, treatment, and non-operative and operative outcomes of medial epicondyle fractures, ulnar collateral ligament repair, osteochondritis dissecans of the elbow, and olecranon stress fractures. RECENT FINDINGS: Acceptable outcomes with both non-operative and operative treatments of medial epicondyle fractures have been reported, with surgical indications continuing to evolve...
February 14, 2018: Current Reviews in Musculoskeletal Medicine
Scott D Peters, Garrett S Bullock, Adam P Goode, Grant E Garrigues, David S Ruch, Michael P Reiman
BACKGROUND: 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. METHODS: A computer-assisted literature search of PubMed, CINAHL, Embase, and SportDiscus databases using keywords related to RTS for UCLI was implemented. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used for study methodology...
March 2018: Journal of Shoulder and Elbow Surgery
Jin-Young Park, Beom Ho Seo, Kyung-Ho Hong, Jae-Hyung Lee, Kyung-Soo Oh, Seok Won Chung, Young-Min Noh
BACKGROUND: Ulnar collateral ligament (UCL) reconstruction has become increasingly popular in elite athletes. However, the prevalence of heterotopic ossification (HO) formation after UCL reconstruction has not yet been reported. We sought to determine the prevalence of HO formation after UCL reconstruction and the clinical outcomes following HO treatment. MATERIALS AND METHODS: From October 2005 to April 2014, 179 patients underwent primary UCL reconstruction. Of the 179 patients, 161 with a minimum of 2 years of follow-up were retrospectively reviewed to evaluate HO formation and clinical outcomes...
March 2018: Journal of Shoulder and Elbow Surgery
Jeremy E Raducha, Joseph A Gil, Andrew Harris, Brett Owens
No abstract text is available yet for this article.
February 6, 2018: JBJS Reviews
Tetsuya Sato, Akimoto Nimura, Reiko Yamaguchi, Koji Fujita, Atsushi Okawa, Keiichi Akita
PURPOSE: To identify the layered relationship anatomically between the musculotendinous structures of the adductor pollicis, the ulnar collateral ligament, and the capsule of the metacarpophalangeal joint in terms of understanding the pathomechanism of a Stener lesion. METHODS: We macroscopically analyzed 37 cadaveric thumbs to identify the intramuscular tendon of the adductor pollicis and bony attachments of the joint capsule including the ulnar collateral ligament...
January 23, 2018: Journal of Hand Surgery
Marc Vetter, Rod J Oskouian, R Shane Tubbs
This paper, although not an exhaustive review of "false" ligaments in the body, describes eight such ligaments. False ligaments are defined as ligamentous structures connecting separate parts of the same bone and are thus immobile. The ligaments reviewed include the suprascapular ligament, the transforaminal lumbar ligaments, the mamillo-accessory ligament, the transverse atlantal ligament, the transverse occipital ligament, the transverse humeral ligament, the coracoacromial ligament, and the transverse part of the ulnar collateral ligament...
November 16, 2017: Curēus
Chengwei Zhou, Jianxiang Xu, Jinti Lin, Renjin Lin, Kai Chen, Jianzhong Kong, Yongzeng Feng, Xiaolong Shui
INTRODUCTION: Dislocation of the elbow associated with radial head and coronoid fracture, the so-called "terrible triad" of the elbow, is challenging to treat and has a history of complicated outcomes. This study is to compare the clinical outcome of a single lateral approach-the extensile splitting extensor digitorum communis (EDC) approach and combined lateral and medial (CML) approaches for the treatment of terrible traid of the elbow (TTE). MATERIAL AND METHODS: After appropriate exclusion, 60 TTE patients (28 patients in the EDC group, 32 patients in the CML group) from 2009 January to 2015 August were reviewed in this study...
January 20, 2018: International Journal of Surgery
Benjamin F Donohue, Marc G Lubitz, Timothy E Kremchek
The "Docking Plus" technique for elbow ulnar collateral ligament (UCL) surgery is described in the following text and video. Depite the general success of UCL surgery, significant rates of retear and failure of return to competition persist. Hypothesized reasons for UCL surgery failure include insufficient graft strength (midsubstance tears), insufficient graft tensioning (functional UCL insufficiency, valgus extension overload), and insufficient healing of graft to bone (proximal avulsions). This technique is meant to incorporate the best aspects of the previously described techniques for UCL reconstruction to create a larger, stronger, better-tensioned graft with a larger healing surface area to bone, a lower retear rate, and a lower risk of complications...
August 2017: Arthroscopy Techniques
Christopher L Camp, Joaquin Sanchez-Sotelo, Maegan N Shields, Shawn W O'Driscoll
Reconstruction of the lateral ulnar collateral ligament of the elbow is the primary treatment for recurrent symptomatic posterolateral rotatory instability. Although a number of lateral ulnar collateral ligament reconstruction techniques have been described, the docking technique has received general acceptance. In this technique, the graft is passed through a tunnel on the ulnar side and the 2 free limbs are docked into the humerus at the isometric point on the lateral condyle. Advantages of this method of reconstruction include reduced bone removal, decreased soft tissue damage, and precise control of graft tensioning...
August 2017: Arthroscopy Techniques
M Wagner, W Schmoelz, H Stofferin, R Arora
Different types of intraosseous suture anchors can be used for thumb ulnar collateral ligament (UCL) repair surgery. Some of them have already been tested biomechanically in intact bone; however, there exists little knowledge of their stability when implanted in avulsion fracture. In this biomechanical in vitro study, three anchor types (hard, soft and novel BoneWelding) were tested on 24 fresh frozen human thumbs from 12 body donors. After the repair of an iatrogenic ligamentous UCL rupture, the thumbs were cyclically loaded...
January 20, 2018: Archives of Orthopaedic and Trauma Surgery
Heath P Melugin, Nels D Leafblad, Christopher L Camp, Stan Conte
PURPOSE OF REVIEW: This review examines recent literature on injury epidemiology and prevention in the sport of baseball from youth to professional levels. RECENT FINDINGS: Overuse is the predominant mechanism of injury in youth baseball players. Newer stretching and exercise protocols may help prevent these injuries. At the professional level, however, overuse has not been proven to correlate with increased injury incidence, but pitch counts are still monitored...
March 2018: Current Reviews in Musculoskeletal Medicine
L Ventura-Ríos, M Hayes-Salinas, D Ferrusquia-Toriz, R I Cariño-Escobar, E Cruz-Arenas, J Gutiérrez-Martínez, L González-Ramírez, C Hernández-Díaz
Range of motion (ROM) measured objectively in nodal hand osteoarthritis (NHOA) is missing. Evaluation of collateral ligaments by ultrasound (US) is unknown in NHOA also. To compare ROM in interphalangeal joints in housewives with nodal OA, with a control group by a digital system using angle to voltage (Multielgon). The second objective was to assess correlation between collateral radial and ulnar ligaments thickness and ROM. For this cross-sectional observational study, we assessed 60 hands with symptomatic NHOA and 30 hands of healthy housewives matched for age...
January 19, 2018: Clinical Rheumatology
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