Reconstruction of the ulnar collateral ligament has proved to be a successful method of restoring the valgus stability to the elbow of the overhead-throwing athlete with ligament incompetence or rupture. Although many athletes can rehabilitate and return to sports without reconstruction of an incompetent UCL, overhead-throwing athletes, such as baseball players, often require stabilization to return to their previous level of play. A thorough pre-operative history and physical examination are essential in the management of the athletes, and imaging studies such as MRI are extremely helpful in defining the articular and periarticular anatomy. Associated injuries, such as articular cartilage damage or ulnar nerve injury, must be identified preoperatively and addressed appropriately for a successful result.
Surgical technique and graft selection vary depending on the surgeon's experience and the patient's associated disorders and anatomy. A careful elbow examination under anesthesia and arthroscopy combined with the reconstruction procedure allow for improved joint and ligament evaluation and should be left to an experienced elbow surgeon.
The patient-athlete should be made aware of the prolonged recovery period after ligament reconstruction. To return to the previous level of throwing, he or she must remain committed to a graduated rehabilitation program of 12 to 18 months. This recovery process should be supervised by the surgeon and involve close collaboration among the athlete, coaches, trainers, and physical therapists.
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Since World War II, there has been a tremendous change in the makeup and direction of kid baseball, as it is called. Adults, showing an unprecedented interest in the activity, have initiated and developed programs in thousands of towns across the United States programs that providebr wholesome recreation for millions of youngsters and are often a source of pride and joy to the community in which they exist.