Houston Methodist. Leading Medicine

Elbow FAQ

Question:

I'm looking for any information I can find on an elbow injury that our son got in a wrestling tournament. Tweaked his elbow real good. Ended up with a torn ligament on the inside of his elbow. They call it the UCL. We'll be taking him to the ortho doctor on Monday. What will they be able to do for him?

Answer:

The ulnar collateral ligament (UCL) is located at the elbow. It supports the humerus-to-radius connection and helps stabilize the elbow. The humerus is the upper arm bone. The radius is one of the bones in the forearm. Without this ligament, the force generated by a throwing motion or weight supported on the medial side of the elbow (side closest to the body) is enough to potentially dislocate the joint. Overhead throwing athletes (especially baseball pitchers) are at greatest risk of UCL injuries. Besides baseball pitchers, a smaller number of athletes were included. There were baseball catchers, outfielders, and infielders. Athletes involved in other sports included football players, javelin throwers, tennis players, wrestlers, soccer players, gymnasts, cheerleaders, and pole vaulters. The orthopedic surgeon will complete a patient history and examination to confirm the diagnosis. Imaging studies starting with X-Rays may be taken. A special MRI called magnetic resonance arthrogram (MRA). This type of MRI uses a contrast dye injected into the area to show the presence of bone spurs or other damage. The surgeon could address any of these additional problems if it turns out surgery is needed. Arthroscopic exam may also be done before surgery to confirm elbow instability. The first line of treatment for injuries of this type is really conservative (nonoperative) care under the supervision of both the orthpedic surgeon and a physical therapist. Treatment begins with rest from throwing or weight-bearing activities. Medications to relieve pain and swelling may be prescribed for a short time. Once the painful symptoms are gone, exercises to restore strength and stability are done for a minimum of three months. No stress across the elbow joint is allowed until the patient's elbow is stable again. Then sports-specific exercises can begin. Return-to-sport (in this case, wrestling) is allowed when the patient passes a biomechanical (throwing or weight-bearing) evaluation. If the elbow remains unstable then surgery may be needed. The ligament may be repaired or if there's too much damage, then reconstructive surgery may be necessary. But that's a long way down the road from where you are at the beginning of an acute injury. Your orthopedic surgeon will walk you through the evaluation and treatment process. Each treatment is individual to the athlete's age, severity of injury, and goals. E. Lyle Cain, Jr, MD, et al. Outcome of Ulnar Collateral Ligament Reconstruction of the Elbow in 1281 Athletes. In The American Journal of Sports Medicine. December 2010. Vol. 38. No. 12. Pp. 2426-2434.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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