Primary Repair of Proximal Ulnar Collateral Ligament Ruptures in Pediatric Overhead Athletes

Ulnar collateral ligament (UCL) injury is commonly seen in overhead throwing athletes resulting from the repetitive valgus stress placed on the medial elbow. UCL injuries (attenuation, insufficiency, or rupture) can result in medial elbow pain, a loss of pitch velocity and accuracy, and increased fatigue. Diagnosis can be made by performing a thorough physical examination along with imaging if indicated, such as ultrasound or magnetic resonance imaging. Treatment options include nonoperative in recreational athletes or those whose primary positions in sport are not high-volume throwing, such as position players in baseball. If nonoperative treatment fails, or the patient has potential for future high-level overhead activity such as a baseball pitcher, surgical repair or reconstruction may be indicated. This article describes our surgical technique for UCL repair in pediatric baseball pitchers.