Return to play after UCL injury in gymnasts.

IF 1.9 4区医学 Q2 ORTHOPEDICS

Physician and Sportsmedicine Pub Date : 2024-10-15 DOI:10.1080/00913847.2024.2414462

Bryson R Kemler, Donald P Willier, Taylor D'Amore, Steven B Cohen, Christopher C Dodson, Michael G Ciccotti

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引用次数: 0

Abstract

Background: Injuries to the ulnar collateral ligament (UCL) are commonly reported in traditional overhead sports. Conversely, there is a lack of evidence outlining management and return to play (RTP) outcomes for gymnasts. This study aimed to evaluate RTP and patient reported outcomes (PROs) in gymnasts after operative and non-operative treatment of UCL injuries.

Methods: Gymnasts who presented with UCL injury and underwent operative and non-operative treatment were evaluated. Patient reported outcomes were collected via telephone: Conway-Jobe Scale, Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow (KJOC) Score, Mayo Elbow Performance (MEP) Score, and quick DASH (qDASH) and Timmerman-Andrews (TA) Elbow Score.

Results: Nine patients met inclusion criteria and were available for follow-up. Five were initially treated operatively and four were initially treated non-operatively. The operative group initially consisted of three ulnar collateral ligament reconstructions (UCLR) and two UCL repairs with internal bracing. One patient crossed over to the operative group after failing non-operative treatment and underwent UCLR four months post injury. Overall, 66.7% and 100% of operatively and non-operatively treated gymnasts were able to return to play, respectively. At final follow-up, the operative groups' mean KJOC, MEP, TA, and qDASH scores were: 68.4 ± 7.7, 97.5 ± 2.7, 90.8 ± 10.7, and 1.9 ± 3.0, respectively. For the non-operative group, the mean scores were 67.4 ± 9.0, 71.7 ± 5.8, 71.7 ± 14.4, and 11.4 ± 9.9, respectively. Treatment satisfaction for the operative group was 81.7 ± 27.5 compared to 80.6 ± 34.5 in the non-operative group. Odds ratios indicated no differences between groups.

Conclusion: Both operative and non-operative interventions for UCL injuries in gymnasts can provide favorable outcomes with respect to return to play and subjective patient-reported outcomes. Further research is warranted to determine optimal treatment, especially regarding indications for operative vs. nonoperative treatment, of UCL injury based on injury severity and location in gymnasts.

Level of evidence: Case series; Level III Evidence.

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体操运动员 UCL 损伤后重返赛场。

背景：尺侧副韧带（UCL）损伤常见于传统的高抬腿运动。与此相反，关于体操运动员的治疗和恢复比赛（RTP）结果的证据却很缺乏。本研究旨在评估体操运动员 UCL 损伤手术和非手术治疗后的 RTP 和患者报告结果（PROs）：方法：对出现 UCL 损伤并接受手术和非手术治疗的体操运动员进行评估。通过电话收集患者报告结果：结果：9 名患者符合纳入标准，并接受了手术和非手术治疗：九名患者符合纳入标准并接受了随访。五名患者最初接受了手术治疗，四名患者最初接受了非手术治疗。手术组最初包括3例尺侧副韧带重建术（UCLR）和2例带内支撑的UCL修复术。一名患者在非手术治疗失败后转入手术组，并在受伤后 4 个月接受了尺侧韧带重建术。总体而言，接受手术治疗和非手术治疗的体操运动员中，分别有 66.7% 和 100% 的人能够重返赛场。在最后的随访中，手术组的 KJOC、MEP、TA 和 qDASH 平均得分分别为68.4 ± 7.7、97.5 ± 2.7、90.8 ± 10.7 和 1.9 ± 3.0。非手术组的平均得分分别为（67.4 ± 9.0）、（71.7 ± 5.8）、（71.7 ± 14.4）和（11.4 ± 9.9）。手术组的治疗满意度为（81.7 ± 27.5），而非手术组为（80.6 ± 34.5）。两组间的比值比无差异：结论：对于体操运动员的 UCL 损伤，手术和非手术疗法都能在恢复比赛和患者主观报告结果方面提供有利的结果。根据体操运动员的损伤严重程度和部位，有必要进一步研究确定最佳治疗方法，尤其是手术治疗与非手术治疗的适应症：证据等级：三级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Physician and Sportsmedicine PRIMARY HEALTH CARE-ORTHOPEDICS

CiteScore

4.90

自引率

4.30%

发文量

审稿时长

>12 weeks

期刊介绍： The Physician and Sportsmedicine is a peer-reviewed, clinically oriented publication for primary care physicians. We examine the latest drug discoveries to advance treatment and recovery, and take into account the medical aspects of exercise therapy for a given condition. We cover the latest primary care-focused treatments serving the needs of our active patient population, and assess the limits these treatments govern in stabilization and recovery. The Physician and Sportsmedicine is a peer-to-peer method of communicating the latest research to aid primary care physicians’ advancement in methods of care and treatment. We routinely cover such topics as: managing chronic disease, surgical techniques in preventing and managing injuries, the latest advancements in treatments for helping patients lose weight, and related exercise and nutrition topics that can impact the patient during recovery and modification.