Bixby Elise C, Ahmed Rifat, Skaggs Kira, Swindell Hasani W, Fortney Thomas A, Ahmad Christopher S
Columbia University Irving Medical Center, New York, New York, USA.
Orthop J Sports Med. 2023 Jul 14;11(7):23259671231183486. doi: 10.1177/23259671231183486. eCollection 2023 Jul.
Patients are faced with several treatment decisions after an ulnar collateral ligament (UCL) injury: nonoperative versus operative treatment, repair versus reconstruction, and immediate versus delayed surgery.
PURPOSE/HYPOTHESIS: The aim of this study was to investigate the factors important to patients when deciding which treatment to pursue after a UCL injury. We hypothesized that (1) length of time away from sports and seasonal timing would be important to patients and (2) treatment decision-making would be heavily influenced by how many and which seasons of their baseball career would be missed.
Cross-sectional study.
High school and collegiate baseball players with UCL tears treated at an academic institution were surveyed retrospectively on their sports participation at the time of injury and their UCL injury treatment decisions. Respondents rated the influence of various factors on a 5-point Likert scale, and they selected the top 3 factors and the single most important factor influencing their treatment decisions. Multiple logistic regression analysis was used to assess the relationship between player characteristics and factors important to their treatment decision.
A total of 83 athletes completed the survey; 40 were in high school and 43 were in college at the time of injury; 7 were treated nonoperatively and 76 underwent surgery (66 immediately and 10 in a delayed fashion), 10 with UCL repair and 66 with UCL reconstruction. The ability to play competitive baseball in the long term was very important or extremely important to 90% of players, while the ability to play in the short term was very important or extremely important to 17%. Length of recovery and seasonal timing were also important factors for 53% and 54% of players, respectively, and almost all (90%) highly valued advice from a surgeon. Possible failure of nonoperative treatment leading to increased time away and the possible loss of 2 consecutive baseball seasons heavily influenced decision-making in 41% of respondents.
Survey respondents were driven by the desire to play baseball in the long term. Treatment decisions were influenced by the length of recovery and by the seasonal timing of their injury, both of which affect how many and which seasons of baseball a player may miss. Patients found advice from their surgeon to be extremely important to decision-making.
尺侧副韧带（UCL）损伤后，患者面临多种治疗决策：非手术治疗与手术治疗、修复与重建，以及即刻手术与延迟手术。
目的/假设：本研究的目的是调查患者在决定UCL损伤后采取何种治疗时，哪些因素对他们很重要。我们假设：（1）远离运动的时间长度和季节时间对患者很重要；（2）治疗决策将受到其棒球生涯错过的赛季数量和赛季的严重影响。
横断面研究。
对在一所学术机构接受治疗的尺侧副韧带撕裂的高中和大学棒球运动员，就其受伤时的运动参与情况及尺侧副韧带损伤的治疗决策进行回顾性调查。受访者用5分李克特量表对各种因素的影响进行评分，并选出影响其治疗决策的前3个因素和最重要的单个因素。采用多元逻辑回归分析来评估运动员特征与对其治疗决策重要的因素之间的关系。
共有83名运动员完成了调查；受伤时40名是高中生，43名是大学生；7名接受非手术治疗，76名接受手术（66名即刻手术，10名延迟手术），10名进行尺侧副韧带修复，66名进行尺侧副韧带重建。长期能够参加有竞争力的棒球比赛对90%的运动员非常重要或极其重要，而短期内能够参赛对17%的运动员非常重要或极其重要。恢复时间和季节时间分别对53%和54%的运动员也是重要因素，几乎所有（90%）运动员都高度重视外科医生的建议。非手术治疗可能失败导致远离运动的时间增加以及可能连续错过两个棒球赛季，对41%的受访者的决策有重大影响。
调查对象受长期打棒球愿望的驱使。治疗决策受恢复时间和受伤季节时间的影响，这两者都会影响运动员可能错过的棒球赛季数量和赛季。患者发现外科医生的建议对决策极其重要。
