Ulnar collateral ligament of elbow joint

On one hand, we do see thicker ligaments in people who throw baseballs, right? The ligament adapts, it does become a little bit more bolstered in response to the chronic stress of throwing.

But at the same time, if you have a compromised ligament from a partial UCL tear or something like that, it is going to be definitely a stabilization deficit over the course of time.

So you want to gradually stress that ligament, but at the same time, you don't want to overdo it and wind up in trouble.

Now, here's the thing that's really, really important.

When you look at the inside of an elbow, right, your ulnar collateral ligament connects your humerus to your ulnar, right? So it crosses the inside of the joint and provides medial elbow stability.

What also crosses that joint is your common flexor tendon, your pronator teres.

All these things come in and attach on the medial epicondyle right next to the UCL.

So we have all these structures, particularly flexor carpi ulnaris, that basically need to be strong to protect the ligament.

When I deal with the snapping triceps, there's never a complaint about muscle weakness, even in a high-level athlete.

What's interesting is when we come to meetings like this, and we all come to learn new things, and sometimes what we take away is that others reinforce what we do, or what we already know, and one of those things for me was, I was in a sports session, because I hate talking about nerve, and we were talking about nerve, and The concept of those with a UCL at the elbow who also have ulnar nerve symptoms, we all, I think, agree if they have ulnar nerve symptoms, the nerve gets transposed.

Some transposed, some hand surgeons who do UCLs will transpose every nerve.

I'm not really in that camp.

I think many sports surgeons who do UCLs don't transpose anyone.

But what's fascinating to me, and I'd be interested if others have strong opinions, is when you treat an ulnar nerve in the setting of a UCL injury, it is the hardest transpositions that I do because there is significant scar tissue.

I mean, it's not fundamentally hard, so to speak, but it is more time consuming and I take a little more care than I usually do because the soft tissues aren't normal and it's just a different operation.

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