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Nonoperative Treatment of Ulnar Collateral Ligament Injuries in Throwing Athletes

Arthur C. Rettig, MD^,, Colin Sherrill, MD, Dale S. Snead, MD, J. Chris Mendler, MD^|| and Paul Mieling, MS, OTR, ATC/L

Methodist Sports Medicine Center, Thomas A. Brady Clinic, New Brunswick, New Jersey
Indiana University School of Medicine, Department of Orthopaedic Surgery, Indianapolis, Indiana, New Brunswick, New Jersey
^|| Rutgers University, New Brunswick, New Jersey

Presented at the 25th annual meeting of the AOSSM, Traverse City, Michigan, June 1999, and at the 67th annual meeting of the American Academy of Orthopaedic Surgeons, Orlando, Florida, March 2000.

Address correspondence and reprint requests to Arthur C. Rettig, MD, Methodist Sports Medicine Center, 201 Pennsylvania Parkway, Suite 200, Indianapolis, IN 46280

Ulnar collateral ligament injury of the elbow in throwing athletes is a common occurrence, and either operative or nonoperative treatment is an option. The results of operative repairs and reconstructions have been well documented in the literature; however, little information has been reported on the outcome of nonoperative treatment. From 1994 to 1997, we evaluated 31 throwing athletes with ulnar collateral ligament injuries. The purpose of this study was to determine what percentage of athletes could return to their sport without surgical intervention and to identify factors that would predict return to full competition by an athlete treated nonoperatively. The factors studied included acute versus insidious onset of symptoms, the duration of symptoms before treatment, and age. Nonoperative treatment, which included a minimum of 3 months’ rest with rehabilitation exercises, allowed 42% of the athletes in our study (N = 13) to return to their previous level of competition. Those who did return did so at an average of 24.5 weeks after diagnosis. No predictive findings obtained either through the patient’s history or physical examination were found that would assist the clinician or athlete in predicting the success of nonoperative treatment.

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