Dodson Christopher C, Thomas Adrian, Dines Joshua S, Nho Shane J, Williams Riley J, Altchek David W
Shoulder and Sports Medicine Service, Hospital for Special Surgery, New York, NY 10021, USA.
Am J Sports Med. 2006 Dec;34(12):1926-32. doi: 10.1177/0363546506290988. Epub 2006 Aug 10.
Medial ulnar collateral ligament insufficiency of the elbow can be a devastating injury in the throwing athlete. Reconstruction of the medial ulnar collateral ligament was initially described by Jobe and associates; good clinical results have been described after this procedure. The authors' experience with this technique raised several concerns, and thus the "docking" procedure was developed as an alternative method for medial ulnar collateral ligament reconstruction of the elbow. The early results of the docking technique were good. The authors wish to investigate the intermediate-term clinical results of this method in a large group of athletes.
The docking technique can return overhead-throwing athletes to sport with minimal perioperative morbidity.
Case series; Level of evidence, 4.
During a 3-year period, 100 consecutive overhead-throwing athletes were treated with surgical reconstruction using the docking technique. The inclusion criteria were as follows: (1) a history of medial elbow pain that prevented throwing, (2) a preoperative standard noncontrast magnetic resonance image demonstrating medial ulnar collateral ligament injury, (3) clinically apparent medial ulnar collateral ligament insufficiency, and (4) an overhead-throwing athlete. At the time of surgery, all patients underwent routine arthroscopic assessment. The ulnar nerve was transposed in 22 cases. The mean follow-up was 36 months (range, 24-60 months).
Ninety of 100 (90%) patients were able to compete at the same or a higher level than before medial ulnar collateral ligament injury for more than 12 months as noted at the follow-up interval; 7 patients were able to compete at a lower level. Only 3 patients suffered postoperative complications.
The docking technique reliably returns athletes to competitive throwing with a low perioperative morbidity.
肘部尺侧副韧带内侧损伤对于投掷运动员来说可能是一种极具破坏性的损伤。尺侧副韧带内侧重建最初由乔布及其同事描述；该手术后已报道有良好的临床效果。作者运用此技术的经验引发了一些担忧，因此开发了“对接”技术作为肘部尺侧副韧带内侧重建的替代方法。对接技术的早期效果良好。作者希望在一大群运动员中研究该方法的中期临床效果。
对接技术能使过头投掷运动员在围手术期发病率最低的情况下恢复运动。
病例系列；证据等级，4级。
在3年期间，连续100名过头投掷运动员接受了使用对接技术的手术重建治疗。纳入标准如下：（1）有妨碍投掷的内侧肘部疼痛病史；（2）术前标准非增强磁共振成像显示尺侧副韧带内侧损伤；（3）临床上明显的尺侧副韧带内侧功能不全；（4）过头投掷运动员。手术时，所有患者均接受常规关节镜评估。22例患者进行了尺神经移位。平均随访时间为36个月（范围24 - 60个月）。
随访期间发现，100例患者中有90例（90%）能够在与尺侧副韧带内侧损伤前相同或更高水平上进行超过12个月的比赛；7例患者能够在较低水平上进行比赛。仅3例患者出现术后并发症。
对接技术能可靠地使运动员恢复有竞争力的投掷，且围手术期发病率较低。
