The Ulnar Collateral Ligament Injury Evaluation and Treatment

The first description of a tear of the ulnar collateral ligament (UCL) (Fig. 1) appeared in a 1946 report by Waris that focused on elbow injuries in javelin throwers1. However, it was not until 1974 that the first UCL reconstruction (UCLR) was performed by Dr. Frank Jobe on Los Angeles Dodgers pitcher Tommy John2. Several modifications of this procedure have been performed since the initial description (Table I)2-12. Although primary repair of the anterior band of the UCL also has been associated with encouraging results in nonprofessional pitchers and adolescents when performed for proper indications (proximal or distal UCL injuries that do not involve midsubstance tears), the results of primary repair in Major League Baseball (MLB) pitchers have been inferior to those of reconstruction, and thus reconstruction has become the gold standard of surgical treatment