Management of UCL Injuries: Primary and Revision

Ulnar collateral ligament injuries are prevalent among baseball players with an increasing incidence, especially in younger athletes. Diagnosis relies on history, examination, and MRI, with dynamic imaging playing an expanding role. Nonoperative management prioritizes cessation of throwing, correcting kinetic chain deficiencies, and gradual rehabilitation. The decision between reconstruction and repair is based on tear characteristics, tissue quality, patient goals, position, and timing of injury. Primary surgery generally results in high return-to-play rates. Revision surgery has less favorable outcomes with more complications. Emerging trends include the use of hybrid reconstruction techniques for challenging cases and platelet-rich plasma to augment nonoperative care.