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Bones of the Upper Limb: Ulna

Bones of the Upper Limb: Ulna

The ulna and radius are parallel bones of the antebrachium or the forearm. The ulna lies medially and consists of a bony tip called the olecranon process at its proximal end. This hook-like projection articulates with the olecranon fossa of the humerus and forms the "hinged" ulnohumeral part of the elbow joint. This joint facilitates forearm extension and flexion while preventing its hyperextension. Similarly, the coronoid process, another bony projection on the proximal/anterior side...

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Ulnar Collateral Ligament Reconstruction: The Rush Experience.

Brandon J Erickson¹, Bernard R Bach¹, Mark S Cohen¹

¹Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois USA.

Orthopaedic Journal of Sports Medicine

|February 11, 2016

Summary

Ulnar collateral ligament reconstruction (UCLR) in athletes shows high success rates. Most collegiate athletes return to sport after UCLR, achieving good functional outcomes with common graft types.

Keywords:

Tommy John baseball elbow injury pitcher surgical treatment ulnar collateral ligament reconstruction (UCLR)

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Area of Science:

Orthopedic Surgery
Sports Medicine
Reconstructive Surgery

Background:

Ulnar collateral ligament reconstruction (UCLR) is a frequent surgical procedure for athletes across professional, collegiate, and high school levels.
The ulnar collateral ligament is crucial for elbow stability in throwing athletes.

Purpose of the Study:

To analyze patient demographics, surgical methods, and outcomes of Ulnar collateral ligament reconstruction (UCLR) procedures.
To provide insights into the effectiveness of UCLR in a diverse athletic population.

Main Methods:

A single-institution case series (Level of evidence, 4) reviewed 187 patients (188 elbows) undergoing UCLR between 2004 and 2014.
Data collected included patient demographics, sport, athletic level, surgical technique (docking/double-docking), graft type (palmaris longus/hamstring), and complications.
Outcomes assessed via phone calls included return-to-sport rates and functional scores (Conway-Jobe, Andrews-Timmerman, Kerlan-Jobe Orthopaedic Clinic [KJOC]).

Main Results:

The study included 187 patients (92% male, mean age 19.6 years), predominantly baseball players (87.8%), with most being collegiate athletes (51.6%).
The docking technique (58.5%) and ipsilateral palmaris longus graft (58.5%) were most common.
Follow-up data (mean 60 months) on 85 patients showed a 94.1% return-to-sport rate with good/excellent Conway-Jobe scores, a mean KJOC score of 90.4, and a mean Andrews-Timmerman score of 92.5.

Conclusions:

Ulnar collateral ligament reconstruction (UCLR) is most frequently performed on collegiate athletes, often utilizing an ipsilateral palmaris longus graft.
The procedure demonstrates high efficacy, with a significant majority of athletes returning to their sport with excellent functional outcomes.