Ulnar Collateral Ligament Injuries
The ulnar collateral ligament (UCL) is an important stabilizing band located on the medial (inside) of the elbow.It is composed of 3 separate identified bands which form a triangle. This complex of ligaments attaches the humerus (arm bone) to the ulna (forearm bone). Like all ligament injuries, it can be a minor stretching or a complete tear or detachment of the ligament from the bone. This can be associated with an acute traumatic injury such as a dislocation or subluxation or it can be associated with a repetitive stress on the ligament resulting in cumulative damage. This is especially noted in overhead thrower/pitchers. The diagnosis of an injury is made based on physical examination but often requires an MRI for grading of the injury.
Treatment of the Injured UCL
Mild tearing of the UCL can often be successfully treated with non-operative measures. This can include observation, avoidance of the causative activities, icing and anti-inflammatory medications (oral and injectable). There may be a period of immobilization with eventual physical therapy exercises.
In patients with persistent pain, elbow instability, or in high level athletes, UCL reconstruction may be necessary. This is commonly known as the “Tommy John” procedure. Dr. Lenarz performs this reconstruction using a tendon from the forearm. The use of cadaver ligaments is also occasionally used, but autograft (from the patients own body) is the preferred method. Post-operatively, patients are immobilized for a period of 6 weeks while the ligament reconstruction heals. The activity is slowly progressed with most restoring normal function in 3 months.