UCL Throwing Injuries in Nonprofessional Baseball Players: A 14-Year Retrospective Study

Jason L Zaremski; Marissa Pazik; Harold Hunt; William S Dodd; Binh K Nguyen; Kevin W Farmer; MaryBeth Horodyski

doi:10.1177/19417381241238966

UCL Throwing Injuries in Nonprofessional Baseball Players: A 14-Year Retrospective Study

Sports Health. 2024 Mar 29:19417381241238966. doi: 10.1177/19417381241238966. Online ahead of print.

Authors

Jason L Zaremski¹, Marissa Pazik², Harold Hunt³, William S Dodd⁴, Binh K Nguyen⁴, Kevin W Farmer², MaryBeth Horodyski²

Affiliations

¹ Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville, Florida.
² Department of Orthopaedic Surgery and Sports Medicine, University of Florida, Gainesville, Florida.
³ Department of Radiology, University of Florida, Gainesville, Florida.
⁴ University of Florida College of Medicine, University of Florida, Gainesville, Florida.

PMID: 38553685
DOI: 10.1177/19417381241238966

Abstract

Background: This study evaluated treatment modality (surgical vs nonoperative) of medial ulnar collateral ligament (UCL) injuries in nonprofessional throwing baseball athletes by comparing type, severity, and location of UCL injury.

Hypothesis: Baseball players with closed medial epicondyle physes and concomitant throwing-related UCL injury will be more likely to undergo surgical intervention than players with open medial epicondyle physes.

Study design: Retrospective.

Level of evidence: Level 5.

Methods: A total of 119 baseball players with a mean age of 16.9 ± 2.5 years (range, 11-25 years) were included in the study. Datapoints included sex, age at time of injury, severity, and location of UCL injury, growth plate status, operative versus conservative management, and concomitant flexor forearm injury.

Results: A total of 75 players were treated conservatively; 43 underwent UCL reconstruction (UCL-R), and 1 had an unknown treatment outcome. No significant difference was found for age related to treatment type, UCL-R (17.2 ± 2.2) versus conservative treatment (16.8 ± 2.6). Athletes with closed medial epicondylar growth plates were more likely to undergo UCL-R than athletes with open medial epicondylar growth plates (P = 0.02). There were no significant differences between UCL injury location (42 distal, 37 proximal, 18 combined tear locations, 11 complete tears, and 11 intact UCLs with inflammation) by treatment type (P = 0.09). There was a significant difference for UCL severity (11 complete tears, 96 partial tears) by treatment type (P = 0.03).

Conclusion: Nonprofessional athletes with closed medial epicondylar growth plates and throwing-related UCL injuries were more likely to be treated surgically. Baseball athletes with partial tears, if skeletally immature, require further long-term evaluation.

Clinical relevance: Continued knowledge gains in this area of throwing medicine will further improve our treatment algorithms in nonprofessional baseball players.

Keywords: baseball; elbow; injury; treatment; ulnar collateral ligament.