Ulnar nerve injury in the throwing athlete

Foecse generated during the overhead thro motion make the medial side of the elbow susceptible to tensile injury. Medial elbow pain and neurologic symptoms may be represent iosolated injury to the ulnar nerve, but more often represent a secondary condition caused by an underlying abnormlity, especially valgus instability. A thorough understanding of ulnar nerve anatomy, throwing biomechanics, and clinical acumen are necessary to appropriately care for the overhead athlete with elbow pain. Nonoperative measures may allow the patient to return to throwing but persistent ulnar nerve symptoms often require surgical release. Surgical treatment options for ulnar neuritis include neurolysis, medial epicondylectomy, or anterior transposition (sub-muscular, intramuscular, or subcutaneous). Anterior subcutaneous transposition stabilized with a fascial sling provides nerve decompression and decreased ulnar nerve tensile forces in the throwing athlete with minimal surgical morbidity. Howerver, the surgeon must adequately diagnose and treat andy associated problems (valgus instability) to allow pain-free return to competition.