Ulnar Collateral Ligament Reconstruction Revisited: The Procedure I Use and Why

CONTEXT: Ulnar collateral ligament (UCL) insufficiency of the elbow can be a debilitating injury that often prevents athletes from competing effectively. The overhead athlete is particularly susceptible to this injury because the anterior bundle of the UCL is the primary restraint to the valgus stress that is created during the throwing motion. Repetitive trauma from constant overhead or throwing activity can ultimately render the ligament incompetent and cause recurrent pain and instability. RESULTS: The authors currently use a “docking” technique that provides excellent graft fixation and reduces ulnar nerve related complications. CONCLUSIONS: This article details the assessment of the throwing athlete with valgus instability secondary to UCL insufficiency and highlights the technical aspects for reconstruction. The majority of athletes who undergo UCL reconstruction of the elbow can successfully return to their preinjury function. STRENGTH-OF-RECOMMENDATION TAXONOMY (SORT): A