Ulnar Collateral Ligament Repair

The anterior bundle of the ulnar collateral ligament (UCL) is the primary restraint to valgus force at the elbow, especially during the arm cocking and arm acceleration phases of the overheard throwing cycle. Injuries of the UCL can range from partial thickness tears, end avulsions, or chronic attritional ruptures with poor tissue quality. The incidence of UCL injuries is on the rise, especially among adolescent overhead athletes. If the athlete fails conservative measures, then surgery is recommended for those desiring to return to overhead sports. Over the past 40 years, UCL reconstruction has been the gold standard for all varieties of UCL injuries. Which poses the question, are some patients suitable for repair rather than reconstruction? Despite poor results with early UCL repairs, it has been shown, both biomechanically and clinically, that with proper patient selection and newer repair techniques that UCL repair can allow athletes to participate in accelerated rehabilitation and faster return to play than traditional UCL reconstruction.