Preliminary clinical outcomes of shoelace repair with internal brace for ulnar collateral ligament injuries with chronic avulsion bone fragments in student baseball players.

Background: Ulnar collateral ligament (UCL) repair with internal brace augmentation has demonstrated promising results. Traditionally, chronic avulsion bone fragments (BFs) at the UCL attachment site have been considered as indications for reconstruction. We applied a shoelace repair technique combined with internal bracing in student baseball players with and without such BFs. We hypothesized that favorable clinical outcomes could be achieved regardless of the presence of BFs. This study aimed to evaluate the clinical outcomes of shoelace repair with internal brace technique. Methods: Eighteen student baseball players who underwent shoelace repair with internal brace were included. Based on pre-operative radiographs and computed tomography scans, patients were classified into those with BFs (n = 8) and those without (n = 10). Post-operative outcomes were assessed and compared between the 2 groups using Japan Orthopedic Association sports score, disabilities of the arm, shoulder, and hand sports module, Kerlan-Jobe Orthopedic Clinic score, and time to return to play (RTP). Results: All the patients returned to play. No significant differences were observed between the groups in sports scores ( Conclusion: Shoelace repair with internal brace may be a viable surgical option for UCL injuries with chronic avulsion BFs in carefully selected young athletes with minimal ligament degeneration and good tissue quality, particularly when early RTP is prioritized.