Operative Treatment of Ulnar Collateral Ligament Injury in Female Athletes

Nicholas O Gerard 3rd; Sean C Clark; Michael J O'Brien; Mary K Mulcahey; Felix H Savoie 3rd

doi:10.1177/23259671241235600

Operative Treatment of Ulnar Collateral Ligament Injury in Female Athletes

Orthop J Sports Med. 2024 Mar 19;12(3):23259671241235600. doi: 10.1177/23259671241235600. eCollection 2024 Mar.

Authors

Nicholas O Gerard 3rd¹, Sean C Clark¹, Michael J O'Brien², Mary K Mulcahey², Felix H Savoie 3rd²

Affiliations

¹ Tulane University School of Medicine, New Orleans, Louisiana, USA.
² Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA.

Abstract

Background: Ulnar collateral ligament (UCL) reconstruction has been the standard surgical intervention for elite male athletes with UCL insufficiency. Recently, UCL repair and augmentation with an internal brace has been increasingly performed.

Purpose: To evaluate the clinical and functional outcomes as well as return-to-sport rate after UCL repair in female athletes.

Study design: Case series; Level of evidence, 4.

Methods: Included were 15 female athletes (mean age, 16.5 ± 3.5 years) who underwent UCL repair between 2011 and 2021 at a single institution. Data collected included age, sport played, competition level, symptom onset, previous surgeries, mechanism of injury, surgical intervention, and return to sport. Patients were contacted via phone at minimum 24-month follow-up, and postoperative outcomes were evaluated using the Mayo Elbow Performance Score (MEPS) and the Single Assessment Numeric Evaluation (SANE).

Results: Of the 15 female athletes, there were 4 cheerleaders, 3 softball players, 2 volleyball players, 2 soccer players, 1 gymnast, 1 tennis player, 1 dancer, and 1 javelin thrower. Ten of the 15 athletes (67%) competed at the high school level, 4 (26%) at the collegiate level, and 1 patient (7%) was a recreational volleyball player. In all patients, there was an acute onset of symptoms after injury. Ten patients underwent UCL repair with an internal brace (67% of athletes), while 5 underwent standard UCL repair. The median MEPS for athletes with and without an internal brace was 100 (range, 80-100). There was no significant difference of MEPS (P = .826) or SANE scores (P = .189) between the patients who received an internal brace and those who did not. Thirteen of the 15 athletes (86.7%) returned to sport.

Conclusion: The UCL injuries in the female athletes in this study were the result of acute trauma. Primary UCL repair, both with and without internal bracing, was an effective surgical treatment for returning these athletes to sport.

Keywords: UCL injury; UCL insufficiency; UCL reconstruction; UCL repair.