Return to play rates after ulnar nerve transposition and decompression surgery: a retrospective analysis

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Neuroscience

Background:

• Overhead throwing athletes frequently experience medial elbow pain due to repetitive stress on the ulnohumeral joint.
• This stress can lead to soft-tissue, ligamentous, and ulnar nerve injuries.
• Ulnar neuritis is a common cause of medial elbow pain in this population.

Purpose of the Study:

• To retrospectively analyze the clinical outcomes of ulnar nerve transposition surgery for isolated ulnar neuritis in throwing athletes.
• To determine return-to-play rates and identify any complications associated with the procedure.

Main Methods:

• Included 15 throwing athletes who underwent primary ulnar nerve transposition between 2009-2017.
• Excluded non-throwing athletes, revision surgeries, and concomitant ulnar collateral ligament procedures.
• Assessed outcomes using the Kerlan-Jobe Orthopaedic Clinic Score and a return-to-play questionnaire, with a minimum 2-year follow-up.

Main Results:

• 86.7% of patients were male, with an average age of 19.2 years.
• 13.3% had prior ulnar collateral ligament reconstruction; no surgical complications were reported.
• 13 patients (86.7%) returned to sport, with 53.8% sustaining a subsequent ipsilateral shoulder or elbow injury.

Conclusions:

• Ulnar nerve transposition surgery is effective for enabling throwing athletes to return to sport with low reoperation rates.
• A significant portion of athletes (over 50%) experienced new ipsilateral shoulder or elbow injuries post-surgery.
• Further research is needed to understand and mitigate the risk of secondary injuries in this patient group.