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First published on July 10, 2006, doi:10.1177/0363546506289884
This version was published on October 1, 2006
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The American Journal of Sports Medicine 34:1594-1598 (2006)
© 2006 American Orthopaedic Society for Sports Medicine

The Modified Docking Procedure for Elbow Ulnar Collateral Ligament Reconstruction

2-Year Follow-up in Elite Throwers

George A. Paletta, Jr, MD* and Rick W. Wright, MD{ddagger},{dagger}

From the * Center for the Athlete’s Shoulder and Elbow at the Orthopaedic Center of St Louis, Chesterfield, Missouri, and {ddagger} Department of Orthopaedic Surgery, Washington University School of Medicine at Barnes-Jewish Hospital, St Louis, Missouri

{dagger} Address correspondence to Rick W. Wright, MD, 1 Barnes Jewish Plaza, Suite 11300, St Louis, MO 63110 (e-mail: Rwwright1{at}aol.com).

Background: Ulnar collateral ligament injury is most common in the overhead-throwing athlete. Jobe et al published the first report of ulnar collateral ligament reconstruction in throwing athletes with a 62.5% success rate. Recently, Altchek developed a new docking technique for reconstruction of the ulnar collateral ligament. The authors report the first series using a further modification of the docking technique using a 4-strand palmaris longus graft for reconstruction of the ulnar collateral ligament.

Hypothesis: The modified docking technique yields a high rate of successful return to preinjury level of competition in elite baseball players.

Study Design: Case series; Level of evidence, 4.

Methods: The authors retrospectively reviewed 25 elite professional or scholarship collegiate baseball players who underwent elbow ulnar collateral ligament reconstruction using the modified docking procedure with a minimum 2-year follow-up.

Results: Twenty-three of 25 (92%) were able to return to their preinjury levels of competition. The mean time to return was 11.5 months (range, 10–16 months). Complications included 1 transient postoperative ulnar nerve neurapraxia and 1 stress fracture of the ulnar bone bridge that occurred at 14 months postoperatively, after a full return to pitching.

Conclusion: The modified docking technique yields highly successful return to preinjury level of competition rates (92%) in a select group of elite baseball players.

Key Words: ulnar collateral ligament (UCL) • elbow • pitchers




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