scholarly journals Adolescent Pitcher Fatigue: Ulnar Collateral Ligament Stress, Flexor-Pronator Mass Energy Depletion, and Correlation to Pitch Count

2021 ◽  
Vol 9 (7_suppl4) ◽  
pp. 2325967121S0024
Author(s):  
Manuel Schubert ◽  
Tariq Awan ◽  
Aaron Sciascia ◽  
Emily Pacheco ◽  
Jennifer DeMink ◽  
...  
Keyword(s):  
Grip Strength ◽  
Muscle Glycogen ◽  
Repeated Measures ◽  
Statistical Significance ◽  
Ulnar Collateral Ligament ◽  
Glycogen Storage ◽  
Collateral Ligament ◽  
Time Points ◽  
Subjective Fatigue ◽  
Forearm Flexor

Objectives: There has been a rise in elbow ulnar collateral ligament (UCL) injuries in youth pitchers over recent years. With forearm flexor-pronator mass fatigue, the dynamic stability provided could be diminished placing greater stress on the UCL. Pitch count limits have been instituted in an attempt to help curtail this rise in throwing injuries, especially in youth athletes. In order to provide more objective data regarding current pitch count limits for youth pitchers, the purpose of this pilot study was to evaluate for potential fatigue of the flexor-pronator mass by assessing changes in medial elbow laxity, noninvasively characterizing changes in muscle glycogen storage within the forearm flexor-pronator mass, and evaluating changes in subjective fatigue, strength, range of motion (ROM), pitching velocity, and accuracy with increasing number of pitches thrown by 10-year-old pitchers up to their recommended 75 pitch count limit. Methods: After appropriate power analysis, male pitchers 10 years of age were recruited for the study (n=22). Pitchers threw a total of 75 pitches divided into sets of 25 pitches, with standardized periods of rest in between throws and sets to best simulate a game. Bilateral medial elbow laxity was measured by applying 10 decanewtons of valgus force with a standardized stress device and utilizing ultrasound imaging (Figures 1A-B) prior to pitching and after each pitching set. The change in medial ulnohumeral joint distance (Figure 1C) after stress was applied was calculated from baseline without stress. Relative changes in muscle glycogen storage, detected as changes in echogenicity, within the flexor carpi radialis (FCR) and the flexor digitorum superficialis (FDS)/flexor carpi ulnaris (FCU) muscles were measured non-invasively with ultrasound-based software (Figures 1D-E) and recorded as fuel percentile. Repeated measures analysis of variance and post-hoc testing were used to determine statistical significance (alpha=0.05). Results: There were no significant differences in medial elbow laxity between arms or time points. There was a trend for similar decline in FCR fuel percentile values between each arm, indicating relative decreases in glycogen storage bilaterally. However, only the throwing arm demonstrated a statistically significant decline in fuel percentile from baseline to after 75 pitches (p=0.05). There were no statistically significant differences across time points for FDS/FCU fuel percentile values. Fatigue measurements for both arms were significantly higher at all time points compared to baseline (p≤0.03). Grip strength of the dominant arm after 75 pitches was significantly decreased compared to after 25 pitches (p=0.02). There were no statistically significant changes in other strength measurements, ROM, velocity, or accuracy between all time points. Conclusions: By the recommended 75 pitch count limit in 10-year-olds, subjective fatigue and a decrease in grip strength had occurred. Furthermore, relative glycogen storage of the flexor-pronator mass of the throwing arm decreased between pitching 50 to 75 pitches, but without an increase in medial elbow gapping. This study provides a foundation and raises questions for further objective testing of physiologic changes that occur throughout increasing pitching to better guide pitch count limits and ensure the safety of young athletes

scholarly journals Effects of Ulnar Collateral Ligament Reconstruction on Pitch Selection in Major League Baseball Pitchers

2018 ◽  
Vol 6 (11) ◽  
pp. 232596711881000
Author(s):  
Eric E. Peterson ◽  
Patrick Handwork ◽  
Lonnie Soloff ◽  
Mark S. Schickendantz ◽  
Salvatore J. Frangiamore
Keyword(s):  
Repeated Measures ◽  
Performance Metrics ◽  
Major League Baseball ◽  
Statistical Significance ◽  
Ulnar Collateral Ligament ◽  
Return To Play ◽  
Collateral Ligament ◽  
Significant Difference ◽  
Major League ◽  
Before And After

Background: Ulnar collateral ligament (UCL) injuries represent one of the most common impairments to the throwing arm of professional pitchers. Return to play and postoperative performance metrics have been studied extensively, but pitch selection before and after surgery has not been evaluated. Purpose/Hypothesis: This study aimed to characterize the effects of UCL reconstruction on pitch selection in Major League Baseball (MLB) pitchers. We hypothesized that pitchers will throw fewer fastballs and a greater percentage of off-speed pitches after undergoing UCL reconstruction. Study Design: Retrospective cohort study; Level of evidence, 3. Methods: Using publicly available data, we evaluated MLB pitchers who underwent UCL reconstruction between 2003 and 2014. Pitching data were collected for the 2 seasons before UCL reconstruction as well as the first 2 seasons after reconstruction; the data consisted of the total number of pitches thrown and the percentage of fastballs, curveballs, changeups, and sliders. Repeated-measures analysis of variance was used with post hoc least significant difference pairwise t tests to evaluate for statistical significance at P < .05. Results: Overall, 87 pitchers (mean age, 28.2 ± 3.5 years) met all inclusion and exclusion criteria. There was a statistically significant difference in the total number of pitches thrown before and after surgery ( P < .01) as well as in the percentage of fastballs thrown before and after surgery ( P = .02). There was also a statistically significant increase in the use of curveballs between 1 and 2 years postoperatively (7.5% and 8.8%, respectively; P = .01). No other findings were statistically significant. Conclusion: Pitchers who underwent UCL reconstruction were shown to have a statistically significant decline in the percentage of fastballs thrown postoperatively as compared with before injury, with a compensatory trend toward an increased use of curveballs and sliders.

scholarly journals Effect of Ulnar Collateral Ligament Reconstruction on Pitch Accuracy, Velocity, and Movement in Major League Baseball Pitchers

2020 ◽  
Vol 8 (12) ◽  
pp. 232596712096853
Author(s):  
Braden McKnight ◽  
Nathanael D. Heckmann ◽  
Xiao T. Chen ◽  
Kevork Hindoyan ◽  
J. Ryan Hill ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Major League Baseball ◽  
Ulnar Collateral Ligament ◽  
Poor Performance ◽  
Return To Play ◽  
Collateral Ligament ◽  
Level Of Evidence ◽  
Major League ◽  
The Mean ◽  
Performance Statistics

Background: Ulnar collateral ligament (UCL) reconstruction is frequently performed on Major League Baseball (MLB) pitchers. Previous studies have investigated the effects of UCL reconstruction on fastball and curveball velocity, but no study to date has evaluated its effect on fastball accuracy or curveball movement among MLB pitchers. Purpose/Hypothesis: The primary purpose of this study was to determine the effects of UCL reconstruction on fastball accuracy, fastball velocity, and curveball movement in MLB pitchers. Our hypothesis was that MLB pitchers who underwent UCL reconstruction would return to their presurgery fastball velocity, fastball accuracy, and curveball movement. The secondary purpose of this study was to determine which factors, if any, were predictive of poor performance after UCL reconstruction. Study Design: Case-control study; Level of evidence, 3. Methods: MLB pitchers who underwent UCL reconstruction surgery between 2011 and 2012 were identified. Performance data including fastball velocity, fastball accuracy, and curveball movement were evaluated 1 year preoperatively and up to 3 years of play postoperatively. A repeated-measures analysis of variance with a Tukey-Kramer post hoc test was used to determine statistically significant changes in performance over time. Characteristic factors and presurgery performance statistics were compared between poor performers (>20% decrease in fastball accuracy) and non—poor performers. Results: We identified 56 pitchers with a total of 230,995 individual pitches for this study. After exclusion for lack of return to play (n = 14) and revision surgery (n = 3), 39 pitchers were included in the final analysis. The mean presurgery fastball pitch-to-target distance was 32.9 cm. There was a statistically significant decrease in fastball accuracy after reconstruction, which was present up to 3 years postoperatively ( P = .007). The mean presurgery fastball velocity of 91.82 mph did not significantly change after surgery ( P = .194). The mean presurgery curveball movement of 34.49 cm vertically and 5.89 cm horizontally also did not change significantly ( P = .937 and .161, respectively). Conclusion: Fastball accuracy among MLB pitchers significantly decreased after UCL reconstruction for up to 3 years postoperatively. There were no statistically significant differences in characteristic factors or presurgery performance statistics between poor and non--poor performers.

scholarly journals Alterations in gait velocity and grip strength of stroke survivors following a 12-week structured therapeutic exercise programme

2018 ◽  
Vol 10 (1) ◽  
pp. 76-80 ◽  
Author(s):  
Hammed I. Adebisi ◽  
Adodo S. Monikhe ◽  
Agwubike E. Okey
Keyword(s):  
Grip Strength ◽  
Repeated Measures ◽  
Statistical Significance ◽  
Exercise Programme ◽  
Training Data ◽  
Gait Velocity ◽  
P Value ◽  
Stroke Survivors ◽  
Therapeutic Exercise ◽  
Hemiparetic Stroke

Summary Study aim: This study investigated the alterations in gait velocity and grip strength of stroke survivors following a structured therapeutic exercise programme (STEP). Material and methods: This was a pre-test, post-test experimental study of the effectiveness of a 12-week STEP on gait veloc­ity and grip strength of stroke survivors. A total of 30 hemiparetic stroke survivors participated in the study. The instrument for this study was an adaptation of a training protocol for the training and assessment of gait velocity and grip strength. The participants underwent a 12-week STEP of a frequency of 3 times per week and the training programme focused on exercises aimed at improving the gait velocity and grip strength of the participants. The gait velocity and grip strength were measured before and after the training. Data generated were analysed using descriptive statistics of mean and standard deviation to sum­marize the profile of the participants. The analysis of variance for repeated measures (ANOVA) was used to test the hypotheses. Statistical significance was accepted for a p value of <0.05. Results: The outcome of this study showed that the STEP had significant (p < 0.05) effects on the gait velocity and grip strength of stroke survivors. Meanwhile, there was no significant (p > 0.05) effect of haemorrhagic and ischaemic groups of stroke sur­vivors on gait velocity and grip strength.Conclusion: It was therefore concluded that the use of the STEP can substantially improve the gait velocity and grip strength of stroke survivors.

scholarly journals P0012SHOULD WE DEFINE A NEW STANDARD PRESCRIPTION OF BICARBONATE (HCO3-) IN HEMODIALYSIS (HD)?

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ana Rita Valerio Alves ◽  
Cátia Figueiredo ◽  
HernÂNi Ricardo Martins GonÇAlves ◽  
Karina Lopes ◽  
Flora Sofia ◽  
...  
Keyword(s):  
Renal Disease ◽  
Repeated Measures ◽  
Statistical Significance ◽  
Small Sample ◽  
Categorical Variables ◽  
Blood Levels ◽  
P Value ◽  
Disease Etiology ◽  
Time Points ◽  
Time Point

Abstract Background and Aims One of the aims of the regular, intermittent HD therapy prescribed for patients with end-stage chronic kidney disease, is correction of metabolic acidosis by addition of HCO3- to dialysate fluid. The KDOQI guidelines therapeutic goal is to maintain pre-dialysis HCO3-≥22mmol/L. The aim of the study was to evaluate an individualized HCO3-hemodialysis prescription as a preventing factor of metabolic changes in a HD facility and define a new standard HCO3-prescription. Method 36-month prospective study of patients on online high-flux hemodiafiltration. Every 3 months (13 time points) HCO3-, Calcium (Ca2+), Phosphorus (P+), intact Parathyroid hormone (iPTH) and protein C reactive (PCR) blood levels were analyzed. HCO3-prescription was changed using the following rules: The data collected comprised demographic information, renal disease etiology, comorbidities, HD treatment information and lab results. Categorical variables are presented as frequencies and percentages, continuous variables as means and standard deviations, or medians and interquartile ranges (IQR) for variables with skewed distributions. A p-value&lt;0.05 was considered statistically significant. Statistical analysis was performed using SPSS version 23 for Mac OS X. Results From the 50 patients that were evaluated at Time point 0, only 24 patients completed the follow-up period. Sixteen (66.7%) were males, 54.2% (n=13) diabetic and 58.3% (n=14) hypertensives and the median age was 76 years (IQR 13). At baseline (time point 0), median pH was 7.4 (IQR 0.09) and serum HCO3-26.5 mmol/L (IQR 2.32). At time point 12, pH was 7.35 (IQR 0.12) and serum HCO3-23.25mmol/L (IQR 1.93). A repeated measures ANOVA determined that prescribed HCO3- differed with statistical significance during time (F(2.787,83.308)=39.055, p=0.001), and the post Hoc tests confirmed those assumptions between time point 1 and all the others time points, as an example the mean difference between initial prescribed HCO3-and time point 12 was 5.39mmol/L (p=0.001). Wilcoxon Sign-Rank Tests determined that throughout the analyzed period the serum HCO3- approached the reference serum HCO3- (23mmol/L) that we have defined as ideal (at time point 0, median=26.5mmol/L, Z=4.144, p=0-001; at time point 12, median 23.25mmol/L, Z=1.243, p=0.214). On the other hand, a one sample T-Test determined that the HCO3- prescription differed more in each time point from the 32mmol/L defined as standard (at time point 12, t=-2.798, p=0.01) and approached a new suggested value of 26mmol/L. However, at time point 8, 62.5% (n=15) patients had a HCO3-prescription of 28mmol/L, (t(23)=0.001,p=1) and at that time we had hypothesized that that a prescription of 28 mmol/L should be the new standard. Gender, Diabetes Mellitus, Hypertension, and renal disease etiology did not influence the HCO3- prescription neither serum HCO3-. Conclusion HCO3-prescription and serum HCO3- were not influenced by comorbidities like DM and Hypertension. Our findings suggest that the standard HCO3- prescription of 32mmol/L should be rethought, as an individualized HCO3- prescription could be beneficial for the patient. At this time, we suggest that a prescription of 26 mmol/L should be the new standard. However, the limitations of our findings include the small sample size, so further studies with larger samples should be attempted.

Forearm Flexor Injuries Among Major League Baseball Players: Epidemiology, Performance, and Associated Injuries

2018 ◽  
Vol 46 (9) ◽  
pp. 2154-2160 ◽  
Author(s):  
Justin L. Hodgins ◽  
David P. Trofa ◽  
Steve Donohue ◽  
Mark Littlefield ◽  
Michael Schuk ◽  
...  
Keyword(s):  
Major League Baseball ◽  
Ulnar Collateral Ligament ◽  
Associated Injuries ◽  
Collateral Ligament ◽  
Baseball Players ◽  
Minor League ◽  
Minor Leagues ◽  
The Mean ◽  
Forearm Flexor ◽  
Forearm Injuries

Background: Despite evidence highlighting the importance of the forearm flexor muscles of elite baseball players, no studies have reported on the epidemiology of flexor strains and their associated outcomes. Purpose: To examine the incidence, associated injuries, and outcomes associated with forearm flexor injuries among major and minor league baseball players. Study Design: Cohort study; Level of evidence, 3. Methods: Injury data attributed to forearm flexor injuries among Major League Baseball (MLB) and minor league teams between 2010 and 2014 were obtained from the professional baseball Health and Injury Tracking System. This analysis included the number of players injured, seasonal timing of injury, days spent on the disabled list (DL), preinjury performance data, and subsequent injuries. Results: A total of 134 and 629 forearm flexor injuries occurred in MLB and the minor leagues, respectively. The mean player age was 28.6 and 22.8 years in the MLB and minor leagues, respectively. The mean time spent on the DL for MLB players was 117.0 days, as opposed to 93.9 days in the minor leagues ( P = .272). Interestingly, pitcher performance declined in all categories examined leading up to the season of injury, with significant differences in walks plus hits per inning pitched ( P = .04) and strike percentage ( P = .036). Of MLB players with a forearm injury, subsequent injuries included 50 (37.3%) shoulder, 48 (35.8%) elbow, and 24 (17.9%) forearm injuries. Among injured minor league players, subsequent injuries included 170 (27.0%) shoulder, 156 (24.8%) elbow, and 83 (13.2%) forearm injuries. These rates of subsequent injuries were significantly higher compared with the rates of injuries sustained among players without forearm injuries in both leagues ( P < .001). Finally, 26 (19.4%) MLB and 56 (8.9%) minor league players required an ulnar collateral ligament reconstruction, rates that were significantly higher compared with players without a flexor strain ( P < .001). Conclusion: Flexor-pronator injuries are responsible for considerable time spent on the DL for elite players in MLB and the minor leagues. The most significant findings of this investigation illustrate that a flexor strain may be a significant risk factor for subsequent upper extremity injuries, including an ulnar collateral ligament tear.

scholarly journals Changes in Medial Elbow Joint Space When Elbow Valgus Stress Is Applied at Different Limb Positions and Loads In Vivo

2021 ◽  
Vol 9 (11) ◽  
pp. 232596712110459
Author(s):  
Kanta Yoshioka ◽  
Kanta Matsuzawa ◽  
Tomoya Ikuta ◽  
Sae Maruyama ◽  
Mutsuaki Edama
Keyword(s):  
Repeated Measures ◽  
Elbow Joint ◽  
Ulnar Collateral Ligament ◽  
Elbow Flexion ◽  
Sports Injury ◽  
Joint Space ◽  
Muscle Contractions ◽  
Collateral Ligament ◽  
Valgus Stress

Background: Ulnar collateral ligament (UCL) injury is a common sports injury among overhead-throwing athletes and causes medial elbow pain and instability. UCL injury is generally diagnosed based on symptoms, physical findings, and image evaluation. To standardize the method for evaluating elbow valgus instability, more information is needed regarding changes in the medial elbow joint space (JS) in healthy elbows. Purpose/Hypothesis: The purpose of this study was to measure the JS during the application of elbow valgus stress at different elbow flexion angles and loads and to clarify the presence of defensive muscle contractions during elbow valgus stress. It was hypothesized that the JS will differ according to different limb positions and loads and that defensive contractions will occur when elbow valgus stress is >90 N. Study Design: Controlled laboratory study. Methods: Elbow joints on the nondominant side were examined in 20 healthy male university students (mean age, 21 ± 0.2 years) at 30°, 60°, and 90° of elbow flexion. To create valgus stress on the elbow, loads of 30, 60, 90, 120, and 150 N were applied with a Telos stress device and with gravity stress on the forearm. The medial JS was measured ultrasonographically during the application of elbow valgus stress. Electrodes were attached to the pronator teres muscle, and defensive muscle contractions were measured using electromyography during the application of elbow valgus stress. Repeated-measures analysis of variance and paired t tests were used to compare the JS at each elbow angle and each valgus stress load, and the Bonferroni method was used as a post hoc test. Results: At 30° of elbow flexion, the JS was significantly higher at 30 N versus 0 N and at 60 N versus 0 or 30 N ( P ≤ .018 for all). At 60° of flexion, the JS was significantly higher at 30 N versus 0 N, at 60 N versus 0 and 30 N, and at 90 N versus 0, 30, and 60 N ( P ≤ .024 for all). At 90° of elbow flexion, the JS was significantly higher at 30 N versus 0 N and at 60 N versus 0 and 30 N ( P ≤ .028 for all). Defensive muscle contraction did not occur at any elbow flexion angles at elbow valgus stress ≤60 N. Conclusion: The lack of muscular contraction at elbow valgus stress ≤60 N may reflect the function of the medial collateral ligament. Clinical Relevance: Elbow valgus stress ≤60 N allows for the evaluation of the joint opening.

Evaluating Changes in Shear Modulus of Elbow Ulnar Collateral Ligament in Overhead Throwing Athletes Over the Course of a Competitive Season

2018 ◽  
Vol 1 (4) ◽  
Author(s):  
Seyedali Sadeghi ◽  
Che-Yu Lin ◽  
Dov A. Bader ◽  
Daniel H. Cortes
Keyword(s):  
Mechanical Properties ◽  
Shear Modulus ◽  
Ulnar Collateral Ligament ◽  
College Level ◽  
Clinical Tool ◽  
Collateral Ligament ◽  
Time Points ◽  
Competitive Season ◽  
Repetitive Loading ◽  
Overhead Throwing

The anterior band of the ulnar collateral ligament (UCL) is commonly subjected to repetitive stress in overhead-throwing athletes, causing high subfailure strain and change in mechanical properties of the ligament. Understanding the change in UCL mechanical properties after repetitive loading can help to evaluate the health status of UCL. The objective of this study was to evaluate changes in UCL shear modulus in overhead-throwing, Division I college-level athletes over the course of a competitive season using ultrasound shear wave elastography (SWE). The proposed protocol quantified changes in shear modulus of UCL in 17 baseball players at preseason and season-end time points as well as in five football quarterbacks at preseason, midseason, and season-end time points. The highest shear modulus values were obtained in the nondominant arm at preseason time points in both groups of athletes. The average UCL shear modulus at the season-end decreased by 39.35% and 37.96% compared to the preseason values in dominant and nondominant arms, respectively. This study shows that SWE could quantify changes in the shear modulus of the UCL after repetitive loading, suggesting that it could be a useful clinical tool for evaluating the risk of UCL injury. Further research on injured overhead-throwing athletes is warranted.

scholarly journals SUN-651 Murine Cecal Ligation and Puncture (CLP) Perturbs Phosphorylation of Insulin Receptor Substrate 2 (IRS-2)

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Deepa Mathew ◽  
Julia Barillas ◽  
Tiago Fernandes ◽  
Alexander Kelly ◽  
Omar Yaipen ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Insulin Receptor ◽  
Tyrosine Phosphorylation ◽  
Insulin Signaling ◽  
Repeated Measures ◽  
Intracellular Signaling ◽  
Statistical Significance ◽  
Cecal Ligation ◽  
Enzyme Linked Immunosorbent Assay ◽  
Time Points

Abstract Hyperglycemia is a characteristic finding in sepsis, and its presence worsens outcome (1). Patients with sepsis need larger doses of insulin to reduce glucose levels. This abnormality has been termed “insulin resistance” but the molecular mechanism by which sepsis attenuates the insulin signaling pathway is unknown. Previous work has shown impairment of phosphorylation in several intracellular signaling pathways following CLP, a well-validated murine model of sepsis (2). Phosphorylation of tyrosine in IRS-2 is essential for functional insulin signaling in hepatocytes (3). Therefore the aim of this study was to investigate the effects of CLP on IRS-2 phosphorylation. Hypothesis: CLP attenuates phosphorylation of IRS-2. Methods: All studies were approved by the Feinstein IACUC and conformed to ARRIVE guidelines. CLP was performed on C57Bl6 mice. Before CLP, animals were identified for sacrifice at specific post-procedure time points. To stimulate phosphorylation of IRS-2, insulin was injected in control and CLP mice at 24 and 48 hours post CLP. Following sacrifice, protein was isolated from liver tissue. Protein abundance was determined using immunoblotting. The detection of the phosphorylated form of these proteins was determined by enzyme-linked immunosorbent assay (ELISA) with a phospho-insulin receptor antibody. Statistical significance was determined using ANOVA for repeated measures with a Sidak post-hoc correction. Results: Relative to the control, tyrosine phosphorylation of IRS-2 was significantly (p&lt;0.05) reduced at 24 and 48 hours following CLP. Conclusions: Tyrosine phosphorylation of hepatic IRS2 is attenuated at early time points following CLP. These results are consistent with other studies examining the effects of CLP on intra-cellular signal transduction pathways (1). Further, these results provide evidence that changes in the insulin signaling transduction underlie CLP-induced “insulin resistance”. References: (1) Abcejo et al., Crit Care Med. 2009;37(5):1729-1734. (2) van den Berghe et al, NEngl J Med. 2001;345(19):1359-1367. (3) Valverde et al., Diabetes 2003 Sep; 52(9): 2239-2248.

scholarly journals Perthes-Like Lesion in Wrist Joint: Stripping of Ulnar Collateral Ligament

2018 ◽  
Vol 08 (02) ◽  
pp. 152-156
Author(s):  
Vijay Malshikare
Keyword(s):  
Literature Review ◽  
Grip Strength ◽  
Wrist Joint ◽  
Ulnar Collateral Ligament ◽  
Young Female ◽  
Wrist Pain ◽  
Collateral Ligament ◽  
New Type ◽  
One Year ◽  
Type Of Injury

Background Chronic ulnar-sided wrist pain often proves to be a challenging presenting complaint. A new type of injury to the ulnar collateral ligament (UCL) of the wrist is described in a young female. It is characterized by stripping of UCL from ulnar attachment. Case Description A 32-year-old female sustained an injury after lifting heavy weight. Examination revealed tenderness to the ulnar styloid, terminal radial deviation was painful and decreased grip strength. The arthro-computed tomography (Arthroscanner) diagnosed stripping of ulnar collateral ligament (UCL). The UCL was refixed with transosseous sutures. At one year follow-up, the patient was pain-free with good range of motion and improved grip strength. Literature Review After intense literature review, we found this type of injury was not reported, but we found the same type of injury in the shoulder “Perthes lesion.” Clinical Relevance The UCL stripping of the wrist is a rare entity and undiagnosed on routine investigation. This lesion was only diagnosed on an arthroscanner and was missed on MR study which is commonly used for diagnosed wrist pain. This case is being reported for its rarity and to expand the differential diagnosis of the ulnar-sided wrist pain.

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