Medial Ulnar Collateral Ligament Avulsion in 16M

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PRESENTATION
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POLLS
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OUTCOMES
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VIDEOS
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EVIDENCE
29
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Comments
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CASE DESCRIPTION
AGE 16 / Male
CC Medial elbow pain
HPI A 16-year-old high school, RHD, wrestler presents with right elbow pain following a takedown during a competition where he attempted to break his fall with this outstretched right hand. He felt a pop and instant pain and was unable to continue the match following this. The pain in the elbow has improved but he still has significant feelings of apprehension with the elbow.
PMH Denies any elbow issues prior to this injury. Clavicle fracture was successfully treated non-operatively at age 13.
PE Patient is 6'2 and 208 lbs. The elbow shows full and symmetric motion compared to the contralateral side. Point tenderness over the sublime tubercle with positive moving valgus and milking maneuver. No tenderness over the flexor-pronator tendon and no pain with resisted wrist flexion. Negative tinels over the ulnar nerve and it does not subluxate. No tenderness at the radiocapitellar joint.
Pre-procedure IMAGES:
https://upload.orthobullets.com/cases/101948/84ff2734-09c1-48fb-aac6-9eaba7071f6f_ap..jpg https://upload.orthobullets.com/cases/101948/9c970e62-8345-4753-850c-7c053e75ae54_lateral..jpg
Pre-procedure VIDEOS:
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POLLS
OB Community
1) In addition to plain film radiographs, would you obtain any other imaging studies to guide management?
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2) How would you manage this injury?
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3) If you choose Operative management, how would you treat the medial ulnar collateral ligament injury (MUCL)?
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4) If you choose MUCL Reconstruction, what type of graft would you use?
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5) If you choose MUCL Reconstruction, which technique would you use?
Other
6) If you choose medial ulnar collateral ligament repair (MUCL Repair), how would you secure the ligament repair?
Other
7) If you choose medial ulnar collateral ligament Repair (MUCL Repair), would you use anything to augment the Repair?
Other
8) If you choose medial ulnar collateral ligament Repair (MUCL Repair) with suture augmentation, at what degree of flexion would you tension it?
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9) If you choose medial ulnar collateral ligament Repair (MUCL Repair), how would you manage the ulnar nerve?
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10) If you choose medial ulnar collateral ligament Repair (MUCL Repair), how long would you anticipate until they can return to sporting competition without restrictions?
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CASE OUTCOMES
PROCEDURE 1: Right medial ulnar collateral ligament repair with suture augmentation
Intra-procedure P1
https://upload.orthobullets.com/cases/101948/8fa7c5fa-7993-4b4a-a431-b1b4f8162953_img_0614.jpg https://upload.orthobullets.com/cases/101948/dc7d6f07-756c-4edc-99d9-c0ec828238be_img_0615.jpg https://upload.orthobullets.com/cases/101948/e10c14a1-cfee-4b0d-ab88-87cbb7df6305_img_0618.jpg https://upload.orthobullets.com/cases/101948/5422c22b-ad40-4ec2-bf1a-0333ed7a2ba4_img_0622.jpg
VIDEOS & PODCASTS (7)
EVIDENCE (29)
EXPERT COMMENTS