Ulnar Collateral Ligament (UCL) Injuries of the Elbow
What You Need to Know
- 最常见的UCL损伤是UCL撕裂，通常是渐进的，但也可能发生在单一的创伤事件中.
- 肘关节内侧疼痛是UCL损伤最常见的症状. UCL撕裂有时会在投掷后感觉像“砰”的一声，然后是剧烈的疼痛.
- UCL损伤的诊断是通过体格检查和外翻应力测试来评估肘关节的不稳定性. An MRI scan or may also be taken.
- UCL损伤的治疗范围从休息和物理治疗到手术, depending on the extent of the UCL tear and your health goals.
What is the ulnar collateral ligament?
韧带是一种坚固的组织带，它将骨骼连接在一起，帮助控制关节的运动. A ligament serves as a tether between the bones. 当韧带撕裂时，系带太长，骨头移动太多. 这会导致疼痛、不稳定或松弛感，以及无法工作或运动.
尺侧副韧带复合体位于肘关节内侧(小指或内侧)。. 它一边与肱骨(上臂的骨头)相连，另一边与尺骨(前臂的骨头)相连。. A UCL consists of three bands or divisions: the anterior (front), posterior (back) and transverse (across) bands. 前腱束对于肘关节的稳定性是最重要的.
How do UCL injuries happen?
UCL Tears From Overuse
The UCL can be injured in several ways. 最常见的是，由于韧带的重复性压力，肘关节疼痛逐渐发作. 这在需要使用头顶手臂或投掷的运动员中尤其常见.
UCL Injuries in Children
儿童，尤其是15岁以下的棒球投手，可能会因为反复的压力而患上伦敦大学前交叉韧带撕裂. 重要的是要记住，投掷时的疼痛对幼儿来说是不正常的. It should be addressed immediately to prevent further injury.
A UCL tear shouldn’t be confused with Little League elbow — another overuse injury common in young baseball players. 这是肘关节骨骼末端生长板的损伤.
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Traumatic UCL Injuries
如果你伸直手臂摔倒，尺侧副韧带也可能受伤. 在这种情况下，UCL可能会破裂或从肱骨上脱落，使一小块骨头碎裂. This is called an avulsion fracture, and it’s rare. This type of trauma is sometimes accompanied by elbow dislocation or elbow fracture.
What are the symptoms of a UCL injury?
- 突然的“砰”声或肘部内侧疼痛，导致无法继续投掷.
- 在一段时间的沉重投掷或其他头顶活动后肘部内侧疼痛.
- Pain when accelerating the arm forward, just prior to releasing a ball.
- Tingling or numbness in the pinky and ring fingers.
UCL撕裂造成的不稳定性可能会影响你参加比赛的能力 sports that require throwing. 然而，它不太可能影响你的日常生活活动，比如拎一袋杂货. A UCL tear rarely prevents people from exercising, lifting weights, running or performing other nonthrowing activities.
Elbow Surgery | Michael's Story
大学运动员迈克尔·佩里是一名年轻健康的进攻线卫，直到他在训练后被肘部撞倒. He immediately knew something was wrong. 约翰霍普金斯大学的肘部专家对迈克尔进行了诊断，发现他的伤势有多严重.
How are UCL injuries diagnosed?
Diagnosis is often more difficult than the treatment of a UCL injury. 这些类型的损伤通常由骨科专家或外科医生诊断和治疗 sports medicine expert. UCL撕裂可以通过病史和体格检查来诊断. A valgus stress test, during which a physician tests your elbow for instability, is the best way to assess the condition of the UCL.
An MRI scan and X-ray 还可以用来看尺侧副韧带的变化与受力有关吗. 然而，这些测试很少被用作诊断的唯一依据. 虽然核磁共振扫描可能会显示UCL撕裂，但它可能不是100%准确. 在MRI前向关节注入染料(钆)有时会提高其准确性.
How are UCL injuries treated?
The treatment options for a UCL injury depend on your goals. 如果你想回到繁重的头顶或投掷活动非手术治疗没有帮助, then your doctor might recommend surgical repair of the torn UCL.
Nonsurgical UCL Treatment
This approach aims to stabilize the elbow and offer pain relief. It may include:
- Initial period of rest.
- 非甾体类抗炎药，如阿司匹林、布洛芬、萘普生等.
- Applying ice to the elbow daily until the pain and swelling are gone.
- After inflammation has decreased, 您可以开始物理治疗，以加强肘部周围的肌肉，以补偿撕裂的韧带.
UCL Reconstruction (Tommy John Surgery)
Tommy John Surgery 使用从身体其他部位或捐赠者身上取下的肌腱作为新的UCL. 在尺骨和肱骨上钻隧道以固定新肌腱(移植物)。. 原始韧带的残余可以附着在移植物上以加强它.
How long does recovery after a UCL injury take?
If your UCL tear can be treated without surgery, the recovery may last anywhere from several weeks to several months. It depends on the range of motion you’d like to achieve in the elbow. 你的内科医生和物理治疗师将共同监测你的进展.
If Tommy John Surgery is recommended, the rehabilitation can take nine months to a year, and sometimes longer. 你的肘部将被放置在一个铰链支架上，逐渐增加活动范围，直到你可以完全伸展它. If you plan to return to throwing and compete, 你将需要更严格的物理治疗来加强你的肘部以应对压力. 每个人恢复的速度都不一样，但是回到你的运动中不应该太匆忙. 在移植物愈合之前对其施加过多压力会增加失败的风险.
