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Ulnar Collateral Ligament Reconstruction In Baseball Pitchers

Miami University pitcher Adam Keel underwent Tommy John surgery on 9/15/00 and is fully recovered.

     A torn ulnar collateral ligament used to signify the end of a baseball pitcher's career. Thanks to the inventiveness of Dr. Frank Jobe, a ligament replacement surgery was developed in 1974 which has changed the game of baseball. The torn ligament is now a mere setback that can be overcome in less than a year.
     The original surgical technique involved drilling tunnels in the bones of the elbow joint and weaving the palmaris longus tendon through the tunnels in a figure-of-eight manner. Recent surgical modifications have made the surgery more effective, including reducing damage to the ulnar nerve. These changes consist of a muscle-splitting technique, no ulnar nerve transposition, a bone anchor method, and a docking procedure. For doctors, it is important to understand how the surgery affects players, coaches, and scouts to help assess the best way to aid a player. Those points of view are discussed here.
     A survey I conducted examined the impact of ulnar collateral ligament replacement on ulnar nerve damage symptoms and maximum fastball velocity in baseball pitchers. Of the twenty-four pitchers responding, three experienced ulnar nerve damage symptoms, none of which persisted. Of the twelve pitchers fully recovered from surgery, 3 experienced an increase, 7 remained the same, and 2 decreased their mamimum fastball velocity. Further research comparing the effectiveness of the different procedures is recommended.

Chapter 1-Introduction

Chapter 2-UCL Injury

Chapter 3-Ulnar Collateral Ligament Reconstruction

Chapter 4-Surgical Modifications

Chapter 5-Rehabilitation

Chapter 6-UCL Replacement From Other Perspectives

Chapter 7-The Effect of Ulnar Collateral Ligament Reconstruction


Please e-mail any comments or questions to Carly Kreps at