Langer P, Fadale P, Hulstyn M
Brown Medical School/Rhode Island Hospital, Providence, RI 02903, USA.
Br J Sports Med. 2006 Jun;40(6):499-506. doi: 10.1136/bjsm.2005.025072. Epub 2006 Feb 17.
Ulnar collateral ligament (UCL) insufficiency is potentially a career threatening, or even a career ending, injury, particularly in overhead throwing athletes. The evolution of treating modalities provides afflicted athletes with the opportunity to avoid premature retirement. There have been several clinical and basic science research efforts which have investigated the pathophysiology of UCL disruption, the biomechanics specific to overhead throwing, and the various types of treatment modalities. UCL reconstruction is currently the most commonly performed surgical treatment option. An in depth analysis of the present treatment options, both non-operative and operative, as well as their respective results and biomechanical evaluation, is lacking in the literature to date. This article provides a comprehensive current review and comparative analysis of these modalities. Over the last 30 years there has been an evolution of the original UCL reconstruction. Yet, despite the variability in modifications, such as the docking technique, interference screw fixation, and use of suture anchors, the unifying concepts of UCL reconstruction are that decreased dissection of the flexor-pronator mass and decreased handling of the ulnar nerve leads to improved outcomes.
尺侧副韧带（UCL）功能不全可能是一种危及职业生涯甚至终结职业生涯的损伤，尤其是在过顶投掷运动员中。治疗方式的演变让患病运动员有机会避免过早退役。已经有多项临床和基础科学研究致力于探究尺侧副韧带断裂的病理生理学、过顶投掷特有的生物力学以及各种治疗方式。目前，尺侧副韧带重建是最常实施的手术治疗选择。迄今为止，文献中缺乏对当前非手术和手术治疗选择及其各自结果和生物力学评估的深入分析。本文对这些治疗方式进行了全面的当前综述和比较分析。在过去30年里，最初的尺侧副韧带重建技术不断演变。然而，尽管在诸如对接技术、干涉螺钉固定和缝合锚钉的使用等改良方面存在差异，但尺侧副韧带重建统一的理念是减少对屈肌 - 旋前肌块的解剖以及减少对尺神经的操作可带来更好的结果。
