Vaswani Ravi, White Alex, Dines Joshua
Sports Medicine Institute, Hospital for Special Surgery, New York, NY, USA.
Curr Rev Musculoskelet Med. 2022 Dec;15(6):474-482. doi: 10.1007/s12178-022-09785-0. Epub 2022 Aug 2.
The purpose of this article is to review medial ulnar collateral ligament (UCL) injuries in contact athletes. UCL injuries in overhead throwing athletes are typically chronic attenuation due to repetitive valgus stress on the elbow during the throwing motion. As such, UCL reconstruction is commonly performed for these athletes. In contrast, UCL injuries in contact athletes are usually acute ligament tears or avulsions of a ligament with otherwise normal tissue. Nonoperative treatment is typically the first-line treatment for partial injuries. UCL repair may work well for acute complete injuries and may avoid the donor site morbidity of UCL reconstruction.
Most of the literature regarding UCL injuries have been performed in baseball players. Historically, UCL repair has had poor outcomes in baseball players due to the chronic ligament attenuation. Therefore, much of the recent literature has focused on outcomes of UCL reconstruction, which are generally excellent. However, there is a paucity of literature studying outcomes of UCL injuries in contact athletes and those studying UCL repair. One recent study looked at a new technique for UCL repair with collagen-coated fiber tape augmentation in baseball players and found good short-term outcomes. UCL injuries in contact athletes occur typically as acute tears or avulsions. While UCL reconstruction has typically been recommended as the accepted treatment for UCL tears that require operative treatment, UCL repair may be a good alternative in contact athletes.
本文旨在综述接触性运动运动员的内侧尺侧副韧带(UCL)损伤情况。过头投掷运动员的UCL损伤通常是由于投掷动作中肘部反复受到外翻应力导致的慢性劳损。因此,这些运动员常进行UCL重建手术。相比之下,接触性运动运动员的UCL损伤通常是急性韧带撕裂或韧带撕脱,而周围组织正常。对于部分损伤,非手术治疗通常是一线治疗方法。UCL修复对于急性完全损伤可能效果良好,并且可以避免UCL重建的供区并发症。
大多数关于UCL损伤的文献都是在棒球运动员中开展的。从历史上看,由于韧带慢性劳损,UCL修复在棒球运动员中的效果不佳。因此,近期的许多文献都聚焦于UCL重建的效果,总体而言效果良好。然而,研究接触性运动运动员UCL损伤的文献以及研究UCL修复的文献较少。最近一项研究观察了棒球运动员采用胶原涂层纤维带增强技术进行UCL修复的新技术,发现短期效果良好。接触性运动运动员的UCL损伤通常为急性撕裂或撕脱。虽然UCL重建通常被推荐为需要手术治疗的UCL撕裂的公认治疗方法,但UCL修复对于接触性运动运动员可能是一个不错的选择。