Author(s) :

Neel R. Gupta.

Volume/Issue :

Abstract :

The Ulnar Collateral Ligament (UCL) is the primary stabilizer of the elbow against valgus stress during overhead throwing motions. Injury rates among young athletes especially have risen sharply in recent years, with male athletes aged 15-19 representing 54% of all UCL injuries, sparking a growing interest in reconstruction and the biology behind it. Although advances in surgical techniques and new biological therapies have become more popular, there are still gaps in our understanding of the optimal treatment for each case. Long term outcomes of new techniques, sex-based differences, and differences in injury patterns all influence the choice of treatment. This review evaluates current evidence on UCL injury management in order to help identify the optimal treatment selection criteria and highlight areas in need of more research. Male athletes are more likely to sustain acute distal tears whereas females are more likely to sustain chronic midsubstance injuries. Surgically, the docking technique remains the gold standard due to high return-to-play rates and fewer complications. However, there are new methods arising such as the interference screw and internal bracing that are showing promise in younger athletes and revision cases. Non-surgical treatments including platelet rich plasma or PRP therapy, physical therapy rehabilitation, and bracing have shown variable outcomes but have been seen to be a viable alternative for partial tears. Future research needs to focus on long-term outcomes of newer surgical techniques, optimization of biological therapies, and clarification of sex-based differences in UCL injury and treatment.