American Sports Medicine Institute, Birmingham, AL 35205, USA.
Am J Sports Med. 2010 Dec;38(12):2426-34. doi: 10.1177/0363546510378100. Epub 2010 Oct 7.
The anterior bundle of the ulnar collateral ligament (UCL) is the primary anatomical structure providing elbow stability in overhead sports, particularly baseball. Injury to the UCL in overhead athletes often leads to symptomatic valgus instability that requires surgical treatment.
Ulnar collateral ligament reconstruction with a free tendon graft, known as Tommy John surgery, will allow return to the same competitive level of sports participation in the majority of athletes.
Case series; Level of evidence, 4.
Ulnar collateral reconstruction (1266) or repair (15) was performed in 1281 patients over a 19-year period (1988-2006) using a modification of the Jobe technique. Data were collected prospectively and patients were surveyed retrospectively with a telephone questionnaire to determine outcomes and return to performance at a minimum of 2 years after surgery.
Nine hundred forty-two patients were available for a minimum 2-year follow-up (average, 38.4 months; range, 24-130 months). Seven hundred forty-three patients (79%) were contacted for follow-up evaluation and/or completed a questionnaire at an average of 37 months postoperatively. Six hundred seventeen patients (83%) returned to the previous level of competition or higher, including 610 (83%) after reconstruction. The average time from surgery to the initiation of throwing was 4.4 months (range, 2.8-12 months) and the average time to full competition was 11.6 months (range, 3-72 months) after reconstruction. Complications occurred in 148 patients (20%), including 16% considered minor and 4% considered major.
Ulnar collateral ligament reconstruction with subcutaneous ulnar nerve transposition was found to be effective in correcting valgus elbow instability in the overhead athlete and allowed most athletes (83%) to return to previous or higher level of competition in less than 1 year.
尺侧副韧带（UCL）前束是提供 overhead 运动（尤其是棒球）肘稳定性的主要解剖结构。 overhead 运动员的 UCL 损伤常导致有症状的外翻不稳定，需要手术治疗。
采用游离肌腱移植物重建 UCL，即 Tommy John 手术，将使大多数运动员能够恢复到相同的竞技水平。
病例系列；证据水平，4 级。
在 1988 年至 2006 年的 19 年间，对 1281 名患者采用 Jobe 技术改良法进行 UCL 重建（1266 例）或修复（15 例）。前瞻性收集数据，并对患者进行回顾性电话问卷调查，以确定术后至少 2 年的结果和重返运动表现情况。
942 例患者获得至少 2 年的随访（平均，38.4 个月；范围，24-130 个月）。743 例患者（79%）接受了随访评估和/或在术后平均 37 个月时完成了问卷调查。617 例患者（83%）恢复到之前或更高的竞技水平，包括重建后 610 例（83%）。从手术到开始投掷的平均时间为 4.4 个月（范围，2.8-12 个月），重建后完全恢复比赛的平均时间为 11.6 个月（范围，3-72 个月）。148 例患者（20%）发生并发症，包括 16%为轻微并发症，4%为严重并发症。
采用皮下尺神经移位的 UCL 重建术治疗 overhead 运动员的外翻肘不稳定是有效的，大多数运动员（83%）在不到 1 年内能够恢复到之前或更高的竞技水平。
