Ulnar Collateral Ligament Injuries in Overhead Athletes: Diagnosis, Management, and Clinical Outcomes

Abstract

Ulnar collateral ligament (UCL) injuries are a common source of pain and disability in overhead and throwing athletes. The prolonged nature of healing often results in notable time lost from competitive sports regardless of the definitive management strategy. A thorough history and physical examination are critical in the diagnosis of UCL injury and understanding patient goals and expectations. In carefully selected patients, nonsurgical management, including rest and slow progression back to activities, can result in successful return to sport. Recent literature has suggested that administration of platelet-rich plasma may be effective in aiding in the healing process, particularly in proximal and partial-thickness tears; however, additional study is warranted. UCL reconstruction has been the benchmark for tears not amendable to nonsurgical treatment, with flexor-pronator complex preservation being important. UCL repair has historically been most commonly used in partial avulsions, but indications have yet to be completely well defined. Knowledge regarding appropriate UCL treatment continues to evolve with patient-specific treatment being essential.