Skip to main content

New Aspects in UCL Stabilization

  • Chapter
  • First Online:
Elbow and Sport

Abstract

The elbow is one of the most congruous and stable joint of the body. Although it is not a weight-bearing joint, it can be subjected to high loads when practicing racket or throwing sports or in gymnastics. The elbow is a very congruous joint with two ligamentous complexes: UCL and LCL. They are involved in the pathoanatomy of throwing athletes or in elbow dislocations and instability.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Morrey BF, Askew LJ, Chao EY. A biomechanical study of normal functional elbow motion. J Bone Joint Surg Am. 1981;63(6):872–7.

    CAS  PubMed  Google Scholar 

  2. Safran MR, Baillargeon D. Soft-tissue stabilizers of the elbow. J Shoulder Elbow Surg. 2005;14(1 Suppl S):179S–85.

    Article  PubMed  Google Scholar 

  3. Mehlhoff TL, Noble PC, Bennett JB, Tullos HS. Simple dislocation of the elbow in the adult. Results after closed treatment. J Bone Joint Surg Am. 1988;70(2):244–9.

    CAS  PubMed  Google Scholar 

  4. Murthi AM, Keener JD, Armstrong AD, Getz CL. The recurrent unstable elbow: diagnosis and treatment. Instr Course Lect. 2011;60:215–26.

    PubMed  Google Scholar 

  5. Hildebrand KA, Patterson SD, King GJ. Acute elbow dislocations simple and complex. Orthop Clin North Am. 1999;30:63–79.

    Article  CAS  PubMed  Google Scholar 

  6. Morrey BF, An KN. Articular and ligamentous contributions to the stability of the elbow joint. Am J Sports Med. 1983;11(5):315–9.

    Article  CAS  PubMed  Google Scholar 

  7. Safran M M.D., et al. Current concepts ulnar collateral ligament of the elbow. Arthrosc: J Arthrosc Relat Surg. 2005;21(11):1381–95.

    Article  Google Scholar 

  8. O’Driscoll SW, Jaloszynski R, Morrey BF, An KN. Origin of the medial ulnar collateral ligament. J Hand Surg [Am]. 1992;17:164–8.

    Article  Google Scholar 

  9. Regan WD, Korinek SL, Morrey BF, An K-N. Biomechanical study of ligaments around the elbow joint. Clin Orthop Relat Res. 1991;271:170–9.

    PubMed  Google Scholar 

  10. Callaway GH, Field LD, Deng XH, et al. Biomechanical evaluation of the medial collateral ligament of the elbow. J Bone Joint Surg Am. 1997;79:1223–31.

    CAS  PubMed  Google Scholar 

  11. Morrey BF, Tanaka S, An KN. Valgus stability of the elbow. A definition of primary and secondary constraints. Clin Orthop. 1991;265:187–95.

    PubMed  Google Scholar 

  12. Neill-Cage DJ, Abrams RA, Callahan JJ, et al. Soft tissue attachments of the ulnar coronoid process: an anatomic study with radiographic correlation. Clin Orthop. 1995;320:154–8.

    Google Scholar 

  13. Timmerman LA, Andrews JR. Histology and arthroscopic anatomy of the ulnar collateral ligament of the elbow. Am J Sports Med. 1994;22:667–73.

    Article  CAS  PubMed  Google Scholar 

  14. Morrey BF. Anatomy of the elbow joint. In: Morrey BF, editor. The elbow and its disorders. 3rd ed. Philadelphia: WB Saunders; 2000. p. 13–42.

    Google Scholar 

  15. Morrey BF, An KN. Functional anatomy of the ligaments of the elbow. Clin Orthop. 1985;201:84–90.

    PubMed  Google Scholar 

  16. Armstrong AD, Ferreira LM, Dunning CE, Johnson JA, King GJW. The medial collateral ligament of the elbow is not isometric. Poster exhibit at the 49th annual meeting of the Orthopaedic Research Society, New Orleans; 2003.

    Google Scholar 

  17. An K-N, Morrey BF. Biomechanics of the elbow. In: Morrey BF, editor. The elbow and its disorders. Philadelphia: WB Saunders; 1985. p. 43–61.

    Google Scholar 

  18. Fuss FK. The ulnar collateral ligament of the human elbow joint. Anatomy, function and biomechanics. J Anat. 1991;175:203–12.

    CAS  PubMed  PubMed Central  Google Scholar 

  19. Tullos HS, Schwab GH, Bennett JB, Woods GW. Factors influencing elbow stability. Instr Course Lect. 1982;8:185–99.

    Google Scholar 

  20. Schwab GH, Bennett JB, Woods GW, Tullos HS. The biomechanics of elbow stability: the role of the medial collateral ligament. Clin Orthop. 1980;146:42–52.

    PubMed  Google Scholar 

  21. Floris S, Olsen BS, Dalstra M, Sojbjerg JO, Sneppen O. The medial collateral ligament of the elbow joint: anatomy and kinematics. J Shoulder Elbow Surg. 1998;7:345–51.

    Article  CAS  PubMed  Google Scholar 

  22. Sojbjerg JO, Oveson J, Nielsen S. Experimental elbow stability after transection of the medial collateral ligament. Clin Orthop. 1987;218:186–90.

    PubMed  Google Scholar 

  23. Safran MR. Ulnar collateral ligament injury in the overhead athlete: diagnosis and treatment. Clin Sports Med. 2004;23:643–63.

    Article  PubMed  Google Scholar 

  24. Safran MR, Caldwell GL, Fu FH. Chronic instability of the elbow. In: Peimer CA, editor. Surgery of the hand and upper extremity. New York: McGraw-Hill; 1996. p. 467–90.

    Google Scholar 

  25. O’Driscoll SWM, Lawton RL, Smith AM. the moving valgus stress test for medial collateral ligament tears of the elbow. Am J Sports Med. 2005;33:231–9.

    Article  PubMed  Google Scholar 

  26. Safran MR, Mcgarry MH, Shin S, et al. Effects of elbow flexion and forearm rotation on valgus laxity of the elbow. J Bone Joint Surg Am. 2005;87:2065–74.

    Article  PubMed  Google Scholar 

  27. Azar FM, Andrews JR, Wilk KE, et al. Operative treatment of ulnar collateral ligament injuries of the elbow in athletes. Am J Sports Med. 2000;28:16–23.

    Article  CAS  PubMed  Google Scholar 

  28. Thompson W. Ulnar collateral ligament reconstruction in athletes: muscle-splitting approach without transposition of the ulnar nerve. J Shoulder Elbow Surg. 2001;10:152–7.

    Article  CAS  PubMed  Google Scholar 

  29. Timmerman LA, Schwartz ML, Andrews JR. Preoperative evaluation of the ulnar collateral ligament by magnetic resonance imaging and computed tomography arthrography. Evaluation in 25 baseball players with surgical confirmation. Am J Sports Med. 1994;32:26–31.

    Article  Google Scholar 

  30. Barnes DA, Tullos HS. An analysis of 100 symptomatic baseball players. Am J Sports Med. 1978;6:62–7.

    Article  CAS  PubMed  Google Scholar 

  31. Rettig AC, Sherrill C, Snead DS, Mendler JC, Mieling P. Nonoperative treatment of ulnar collateral ligament injuries in throwing athletes. Am J Sports Med. 2001;29:15–7.

    CAS  PubMed  Google Scholar 

  32. Conway JE, Jobe FW, Glousman RE, Pink M. Medial instability of the elbow in throwing athletes: treatment by repair or reconstruction of the ulnar collateral ligament. J Bone Joint Surg Am. 1992;74:67–83.

    CAS  PubMed  Google Scholar 

  33. Bennett JB, Tullos HS. Ligamentous and articular injuries in the athlete. In: Morrey BF, editor. The elbow and its disorders. Philadelphia: WB Saunders; 1985. p. 502–22.

    Google Scholar 

  34. Norwood LA, Shook JA, Andrews JR. Acute medial elbow ruptures. Am J Sports Med. 1981;9:16–9.

    Article  CAS  PubMed  Google Scholar 

  35. Freehill MT, Safran MR. Diagnosis and management of ulnar collateral ligament injuries in throwers. Curr Sports Med Rep. 2011;10(5):271–8.

    Article  PubMed  Google Scholar 

  36. Vanderhooft E. The frequency of and relationship between the palmaris longus and plantaris tendons. Am J Orthop. 1996;25(1):38–41.

    CAS  PubMed  Google Scholar 

  37. Jobe FW, Stark H, Lombardo SJ. Reconstruction of the ulnar collateral ligament in athletes. J Bone Joint Surg Am. 1986;68:1158–63.

    CAS  PubMed  Google Scholar 

  38. Smith GR, Altchek DW, Pagnani MJ, Keeley JR. A muscle-splitting approach to the ulnar collateral ligament of the elbow. Neuroanatomy and operative technique. Am J Sports Med. 1996;24:575–80.

    Article  CAS  PubMed  Google Scholar 

  39. Andrews JR, Timmerman LA. Outcome of elbow surgery in professional baseball players. Am J Sports Med. 1995;23:407–13.

    Article  CAS  PubMed  Google Scholar 

  40. Altchek DW, Andrew JR. Medial collateral ligament injuries. In: Altchek DW, Andrew JR, editors. The athlete’s elbow. Philadelphia: Lippincott Williams and Wilkins; 2001. p. 153–73.

    Google Scholar 

  41. Rohrbough JT, Altchek DW, Hyman J, Williams III RJ, Butts JD. Medial collateral ligament reconstruction of the elbow using the docking technique. Am J Sports Med. 2002;30:541–8.

    PubMed  Google Scholar 

  42. Ahmad CS, Lee TQ, Elattrache NS. Biomechanical evaluation of a new elbow ulnar collateral ligament reconstruction using interference screw fixation. Am J Sports Med. 2003;31:332–7.

    PubMed  Google Scholar 

  43. Armstrong AD, Dunning CE, Ferreira LM, Faber KJ, Johnson JA, King GJ. A biomechanical comparison of four reconstruction techniques for the medial collateral ligament–deficient. Elbow J Shoulder Elbow Surg. 2005;14:207–15.

    Article  PubMed  Google Scholar 

  44. Koh JL, Schafer MF, Keuter G, Hsu JE. Ulnar collateral ligament reconstruction in elite throwing athletes. Arthrosc: J Arthrosc Relat Surg. 2006;22(11):1187–91.

    Article  Google Scholar 

  45. Large TM, Coley ER, Peindl RD, Fleischli JE. A biomechanical comparison of 2 ulnar collateral ligament reconstruction techniques. Arthroscopy. 2007;23:141–50.

    Article  PubMed  Google Scholar 

  46. McAdams TR, Lee AT, Centeno J, Giori NJ, Lindsey DP. Two ulnar collateral ligament reconstruction methods: the docking technique versus bioabsorbable interference screw fixation–a biomechanical evaluation with cyclic loading. J Shoulder Elbow Surg. 2007;16:224–8.

    Article  PubMed  Google Scholar 

  47. Conway J. The Dane TJ procedure for elbow medial ulnar collateral ligament insufficiency. Tech Should Elbow Surg. 2006;7:36–43.

    Article  Google Scholar 

  48. Ahmad CS, ElAttrache NS. Elbow valgus instability in the throwing athlete. J Am Acad Orthop Surg. 2006;14:693–700.

    PubMed  Google Scholar 

  49. Seiber KS, Savoie FH, McGarry MH, Gupta R, Lee TQ. Biomechanical evaluation of a new reconstruction technique of the ulnar collateral ligament in the elbow with modified bone tunnel placement and interference screw fixation. Clin Biomech. 2010;25:37.

    Article  Google Scholar 

  50. Bennett JM, Mehlhoff TL. Reconstruction of the medial collateral ligament of the elbow. J Hand Surg. 2009;34A:1729–33.

    Article  Google Scholar 

  51. Hechtman KS, Tjin-A-Tsoi EW, Zvijac JE, Uribe JW, Latta LL. Biomechanics of a less invasive procedure for reconstruction of the ulnar collateral ligament of the elbow. Am J Sports Med. 1998;26:620–4.

    CAS  PubMed  Google Scholar 

  52. Pederzini L, Prandini M, Tosi M, Nicoletta F. The acute lesions of the medial collateral ligament of the elbow S14 GIOT Agosto. GIOT. 2012;38(Suppl 2):14–18.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to L. A. Pederzini .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 ESSKA

About this chapter

Cite this chapter

Pederzini, L.A., Di Palma, F., Nicoletta, F. (2016). New Aspects in UCL Stabilization. In: Pederzini, L., Eygendaal, D., Denti, M. (eds) Elbow and Sport. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-48742-6_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-48742-6_6

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-48740-2

  • Online ISBN: 978-3-662-48742-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics