Magnetic Resonance Imaging Predictors of Failure in the Nonoperative Management of Ulnar Collateral Ligament Injuries in Professional Baseball Pitchers

Background Injuries to the ulnar collateral ligament are relatively common in throwing athletes and result from either acute traumatic or repeated valgus stress to the elbow. Avulsion fracture of the sublime tubercle of the ulna is a rarely reported site of ulnar collateral ligament injury. Purpose We retrospectively reviewed our cases of ulnar collateral ligament injuries to study avulsion fractures of the sublime tubercle of the ulna. Study Design Case series. Methods Data, including radiographs and magnetic resonance imaging scans, were obtained by review of hospital and office records and by follow-up examination. Of 33 consecutive patients treated for ulnar collateral ligament injuries, 8 had avulsion fractures of the sublime tubercle of the ulna. All eight were male baseball players with dominant arm involvement, an average age of 16.9 years, and an average follow-up of 23.6 months. Results Six of eight patients had failure of nonoperative treatment and required surgical repair. Two of the six underwent ulnar collateral ligament reconstruction and four had direct repair of the sublime tubercle avulsion with bioabsorbable suture anchors. At last follow-up, all eight had returned to their preinjury level of activity. No patient had residual medial elbow pain or laxity. Conclusions Diagnosis of sublime tubercle avulsion fracture is made with history, physical examination, and radiographic studies. Magnetic resonance imaging can help identify an avulsion fracture not visible radio-graphically and can help determine whether direct repair or reconstruction is needed.

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The value of magnetic resonance imaging and ultrasound in diagnosing displaced rupture of the thumb ulnar collateral ligament

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193420932496 ◽

2020 ◽

Vol 45 (10) ◽

pp. 1098-1100

Author(s):

Ellen Hamborg-Petersen ◽

Trine Torfing ◽

Bjarke Viberg

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Ulnar Collateral Ligament ◽

Resonance Imaging ◽

Collateral Ligament

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MRI Predictors of Failure in Non-operative Management of Ulnar Collateral Ligament Injuries in Professional Baseball Pitchers

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967116s00169 ◽

2016 ◽

Vol 4 (7_suppl4) ◽

pp. 2325967116S0016 ◽

Cited By ~ 1

Author(s):

Thomas Sean Lynch ◽

Salvatore Frangiamore ◽

Michael Derek Vaughn ◽

Lonnie Soloff ◽

Mark S. Schickendantz

Keyword(s):

Ulnar Collateral Ligament ◽

Operative Management ◽

Professional Baseball ◽

Ligament Injuries ◽

Collateral Ligament ◽

Baseball Pitchers ◽

Non Operative Management

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The appearance of the lateral ulnar collateral ligament on magnetic resonance imaging

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2003.12.013 ◽

2004 ◽

Vol 13 (2) ◽

pp. 214-216 ◽

Cited By ~ 30

Author(s):

Nobuki Terada ◽

Harumoto Yamada ◽

Yoshiaki Toyama

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Ulnar Collateral Ligament ◽

Resonance Imaging ◽

Collateral Ligament ◽

Lateral Ulnar Collateral Ligament

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Stress Injury of the Proximal Ulna in Professional Baseball Players

The American Journal of Sports Medicine ◽

10.1177/03635465020300051801 ◽

2002 ◽

Vol 30 (5) ◽

pp. 737-741 ◽

Cited By ~ 64

Author(s):

Mark S. Schickendantz ◽

Charles P. Ho ◽

Jason Koh

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Ulnar Collateral Ligament ◽

Professional Baseball ◽

Resonance Imaging ◽

Baseball Players ◽

Stress Injury ◽

Elbow Pain ◽

Proximal Ulna ◽

Throwing Athlete

Background: To date, stress injury of the proximal ulna has been infrequently reported as a cause of elbow pain in the throwing athlete. Purpose: We describe a syndrome of osseous stress injury of the proximal ulna in the professional throwing athlete. Study Design: Retrospective review. Methods: We evaluated the clinical, radiographic, and magnetic resonance imaging findings of seven professional baseball players with osseous stress injury of the proximal ulna. Results: Plain radiographs of the involved elbows failed to demonstrate any significant findings. All of the clinically significant lesions were detected with magnetic resonance imaging. In addition, magnetic resonance imaging was found to be of value in following the course of healing of the injuries. All of the lesions originated on the posteromedial aspect of the proximal ulna. The ulnar collateral ligament was intact in all seven athletes. One athlete had two occurrences of this injury. Six of the seven athletes returned to their previous level of play after a nonoperative course of treatment. Conclusions: We believe that this injury should be considered in the differential diagnosis of elbow pain in the throwing athlete. Magnetic resonance imaging is the diagnostic test of choice when this injury is suspected.

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Magnetic Resonance Imaging Findings After Elbow Dislocation: A Descriptive Study

Hand ◽

10.1177/1558944720949961 ◽

2020 ◽

pp. 155894472094996

Author(s):

Cory Demino ◽

John R. Fowler

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Flexor Tendon ◽

Elbow Dislocation ◽

Ulnar Collateral Ligament ◽

Magnetic Resonance Images ◽

Joint Effusion ◽

Imaging Findings ◽

Resonance Imaging ◽

Collateral Ligament

Background The elbow is one of the most commonly dislocated joints, and dislocation is usually accompanied with an assortment of soft tissue injuries. The purpose of this study was to retrospectively analyze and describe the patterns of ligamentous, tendinous, and muscular injuries in patients with an acute elbow dislocation and subsequent magnetic resonance image (MRI) evaluation. Methods From 2008 to 2020, 235 patients clinically diagnosed with an elbow dislocation were seen in the department, of which only 19 underwent an MRI of the affected elbow. Twelve patients met inclusion criteria, and MRIs were evaluated by both a radiologist and an upper extremity orthopedic surgeon. Magnetic resonance images were assessed for injury to the ulnar collateral ligament (UCL); radial collateral ligament (RCL); lateral ulnar collateral ligament (LUCL); common flexor and extensor tendons; biceps, brachialis, and triceps tendons; fracture; and joint effusion. Results Magnetic resonance imaging findings included the following: UCL was injured in 11 of 12 patients; RCL was injured in 9 of 12 patients; LUCL was injured in 9 of 12 patients; common flexor tendon was injured in 11 of 12 patients; and common extensor tendon was injured in 9 of 12 elbows. The biceps, brachialis, and triceps tendons showed injury in 1 of 12, 2 of 12, and 2 of 12 elbows, respectively. Four elbows had at least 1 fracture present, whereas 8 demonstrated an effusion. Conclusions In this series, injuries to the UCL and common flexor tendon were most common. Although ligamentous injuries are exceedingly common in elbow dislocations, large studies of MRI findings prove difficult due to MRI costs.

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