Azar F M, Andrews J R, Wilk K E, Groh D
American Sports Medicine Institute, Birmingham, Alabama, USA.
Am J Sports Med. 2000 Jan-Feb;28(1):16-23. doi: 10.1177/03635465000280011401.
Over a 6-year period, the senior author (JRA) performed 91 ulnar collateral ligament reconstructions (N = 78) or repairs (N = 13). All patients were male and between the ages of 15 and 39 years (average, 21.6). Thirty-seven patients (41%) were professional baseball players, 41 (45%) were collegiate baseball players, and 7 (7.7%) were high school or recreational players. Subcutaneous ulnar nerve transposition with stabilization of the nerve with fascial slings of the flexor pronator mass was performed in all patients, and additional procedures were performed in 27 patients (29.7%), including 22 excisions of posteromedial olecranon osteophytes. Average follow-up was 35.4 months. Ten patients had preoperative ulnar nerve symptoms, nine of whom had complete resolution of symptoms after surgery. Complications occurred in eight patients. The average time from surgery to initiation of the interval throwing program was 3.4 months, and the average time to return to competitive throwing was 9.8 months. Sixty-seven patients (74%) were available for follow-up; of these, 53 (79%) had returned to their previous levels of competition or to a higher level. Reconstruction of the ulnar collateral ligament, with transposition and stabilization of the ulnar nerve and appropriate rehabilitation, was found to be effective in correcting medial instability of the elbow and allowed most athletes to return to previous levels of play in less than 1 year.
在6年的时间里，资深作者（JRA）进行了91例尺侧副韧带重建术（N = 78）或修复术（N = 13）。所有患者均为男性，年龄在15至39岁之间（平均21.6岁）。37名患者（41%）是职业棒球运动员，41名（45%）是大学棒球运动员，7名（7.7%）是高中或业余球员。所有患者均进行了皮下尺神经转位，并使用旋前圆肌筋膜吊带固定神经，27名患者（29.7%）还进行了其他手术，包括22例切除尺骨鹰嘴后内侧骨赘。平均随访时间为35.4个月。10名患者术前有尺神经症状，其中9名术后症状完全缓解。8名患者出现并发症。从手术到开始间歇投球训练的平均时间为3.4个月，恢复竞争性投球的平均时间为9.8个月。67名患者（74%）可供随访；其中53名（79%）恢复到了之前的比赛水平或更高水平。尺侧副韧带重建术，结合尺神经转位和固定以及适当的康复治疗，被发现对纠正肘部内侧不稳定有效，并且能让大多数运动员在不到1年的时间内恢复到之前的比赛水平。
