Pls help- UCL rupture & hitting function

DD has unfortunately suffered a grade 3 acute rupture of her Ulnar Collateral Ligament. It happened to her left elbow while diving back to base (she is right handed, this is not a throwing overuse injury).

She still has open growth plates and we have to decide between getting surgery now or later.

Without surgery- she is likely to be back on the diamonds in 6 months, but without a functioning ligament. She would essentially be relying on muscle strength & conditioning. The benefits of this mean that she can finish growing safely and can get back to normal sooner. The negatives are that we would all be living in fear that everything she does might cause another elbow injury. And that at some point she would have to get it done anyway if she wanted to pursue elite levels of sport (which she does).

With surgery- she risks damaging nerves and her growth plates (she still has a lot of growing to do), but in 12 months time she would have some kind of tendon holding things together. This could permanently affect the length of her arm. Although she would miss a lot of opportunities she would be 'fixed' for more serious opportunities further down the track.

While I'm aware of how the UCL is affected during pitching mechanics, I'm not sure how much force etc is used while batting. It is her left arm, she bats right-handed. I know she wont be throwing with her left arm but am concerned that relying on only muscles to bat/extension etc is not going to be ideal.

Her health and safety is our priority, not a game. But I'd still like to know so that we can make an informed decision when both options have many pros & cons.

Prayers sent that your DD makes a full recovery, but I am not qualified to offer any medical advice.

Thanks JAD for the prayers, they are really appreciated.

I dont think it will affect our decision too much, at the end of the day we will go with whatever the surgeon thinks is best.

I was mainly wondering if we choose not to have surgery if I have to worry with every at-bat because of the impact of the swing on her UCL. We've always chosen to prioritize the legs & hips in the swing but I guess the arms have an important job too, just curious how much force & energy in that region! Thanks again.

Cat5 said:

Thanks JAD for the prayers, they are really appreciated.

I dont think it will affect our decision too much, at the end of the day we will go with whatever the surgeon thinks is best.

I was mainly wondering if we choose not to have surgery if I have to worry with every at-bat because of the impact of the swing on her UCL. We've always chosen to prioritize the legs & hips in the swing but I guess the arms have an important job too, just curious how much force & energy in that region! Thanks again.

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My thought would be to let her hit in practice to see how it goes. I would also invest in an elbow guard.

I'm an upper extremity surgeon and I teach how to do tommy-John's reconstruction. If my child with open growth plates has an acute UCL tear, no way I'm fixing it or getting it fixed. To many complications and it probably won't even be necessary. I'd put her in an unlocked hinged elbow brace and rest it for 6-8 weeks. If that fails, you haven't burnt any bridges. Wait until she is done growing then reconstruct it. Just as a side note, I decompress the ulnar nerve but do not transpose it for tommy John's surgery and the studies seem to back me up on that.

Thanks so much Orthodoc, that is pretty similar to the treatment plan we are pursuing.

Really good of you to reply, it's nice to get reassurance. Thank you!