Ulnar Collateral Ligament Injuries of the Elbow

This chapter presents a clinical scenario of a 23-year-old professional baseball pitcher who had longstanding medial-sided pain in his right, dominant, elbow for six months. It is important to distinguish complete ulnar collateral ligament (UCL) tears from partial tears and other medial elbow pathology to establish the right treatment. Recent studies suggest that magnetic resonance imaging-based grading systems may provide diagnostic and prognostic information on the outcome of (non)operative management. UCL reconstruction (UCLR) allows most overhead athletes to return to sports. Over the past decade, the number of UCLRs has significantly increased, especially in adolescent overhead athletes. The public perception of UCLR is positive, with up to 42% of athletes, 20% of coaches, and 35% of parents believing that UCLR leads to enhanced pitching performance beyond that of the preinjury level. The chapter also provides recommendations for implementing evidence-based practice in the clinical setting.