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Ulnar Collateral Ligament Reconstruction
Injury to the elbow ulnar collateral ligament (UCL) in overhead athletes can be career ending. This ligament, which is composed of an anterior, posterior, and transverse bundle, originates at the inferior surface of the medial epicondyle of the humerus and inserts onto the sublime tubercle of the ulna. It is the anterior bundle that serves as the primary restraint to valgus forces of up to 290 N and angular velocities exceeding 3,100°/s that occur during the throwing of a baseball. Each pitch actually approaches the ultimate tensile strength of the ligament, so it is not surprising that repetitive throwing can cause microtrauma and, eventually, complete failure of the ligament.