Ulnar Collateral Ligament Reconstruction With the Modified Jobe Technique in Baseball Pitchers.

backgroundTearing and insufficiency of the ulnar collateral ligament (UCL) of the elbow result in valgus instability, which can lead to pain while throwing and decline in performance in overhead athletes. PURPOSE: To assess the clinical results of a modified UCL reconstruction technique using 1 bone hole in the ulna and 1 bone tunnel in the humerus in baseball players. STUDY

designCase series; Level of evidence, 4.

methodsThe inclusion criteria were medial elbow pain preventing effective playing, clinically medial elbow laxity, and magnetic resonance imaging results consistent with UCL injury. Patients who were engaged in other sports and in other positions in baseball except pitchers were excluded from this study. Our modified Tommy John procedure was performed via a muscle-splitting approach and an original single-bone-tunnel technique, using a suture anchor. After a minimum of 24 months, patients were evaluated using the Conway scale and the Timmerman-Andrews score.

resultsOf 31 patients, 20 baseball pitchers (20 male: 5 high school, 5 collegiate, 8 nonprofessional, and 2 professional pitchers) were reviewed. The mean patient age at the time of operation was 21.9 years, and the mean postoperative follow-up period was 35.1 months (range, 24-66 months). The mean Timmerman-Andrews subjective score improved significantly from pre- to postoperatively (from 68.3 to 98.3;

conclusionUCL reconstruction with 1 bone hole in the ulna and 1 bone tunnel in the humerus demonstrated satisfactory results in baseball pitchers. Our modified technique was safe and achieved satisfactory clinical results, with a 95% rate of return to sports.