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Medial Ulnar Collateral Ligament Rupture in 20M
HPI
A 20-year-old collegiate outfielder presents to you with medial sided elbow pain following a throw from the outfield fence where he felt a pop. He completed some therapy sessions guided by the team trainers and now his elbow pain only bothers him while throwing more than 100ft. He hasn't had any issues with the elbow prior to this injury nor has he had any injections.
PMH
He has an ACL reconstruction with a meniscal repair 2 years prior with an unremarkable recovery. He bats and throws right-handed, and has sophomore collegiate eligibility remaining.
PE
Patient is 6'4 and 210lbs. His elbow ranges from 4 degrees short of full extension to 140 degrees of flexion, and he has full prono-supination There is tenderness over the medial elbow at the sublime tubercle but no pain with resisted wrist flexion. Pain in medial elbow with the moving milking maneuver but no obvious opening with valgus stress.
Right elbow medial UCL reconstruction using ipsilateral palmaris longus graft.
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