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Poster 208. Evaluating Outcomes and Return to Sport of Ulnar Collateral Ligament Injuries in Wrestlers
Abstract   Open access   Peer reviewed

Poster 208. Evaluating Outcomes and Return to Sport of Ulnar Collateral Ligament Injuries in Wrestlers

Richard VanTienderen, Eli Gregory, Brandon Marshall, Shannon F. Ortiz, Brian R. Wolf and Robert W. Westermann
Orthopaedic journal of sports medicine, Vol.14(8_suppl6)
08/01/2026
DOI: 10.1177/2325967126S00505
PMCID: PMC13530635
url
https://doi.org/10.1177/2325967126S00505View
Published (Version of record) Open Access

Abstract

Objective: Ulnar collateral ligament injuries are under-studied in wrestlers despite high injury rates. Unique biomechanical demands may create distinct injury profiles and treatment plans compared to the overhead athlete. Methods: This study is a retrospective review of wrestlers, 12 and older, treated for UCL injuries at a mid-west academic center between 2014-2023. All wrestlers with UCL injuries were included. Patients with unrelated elbow pathology or injuries sustained in other sports were excluded. Data collected included demographics, competition level, injury mechanism, physical exam and imaging characteristics, and treatment modality. Key outcome was ability to return to sport (RTS). Results: We found 46 wrestlers that met inclusion criteria. Average age was 18, BMI ranged from 23.0 to 27.6. Ten athletes were female. 7% were competing in middle school, 52% in high school, 33% in college, 9% in a wrestling club, and 2% at the national level. 89% (41/46) were primarily indicated for non-operative treatment and 11% (5/46) underwent primary surgery. 41% (17/41) of the non-operative treatment group failed conservative management and 44% (18/41) ultimately required surgery. The non-operative treatment group consisted of 3 middle school, 21 high school, 14 collegiate, and 3 club athletes. Of these, 1 middle school, 11 high school, 4 collegiate, and 1 club athlete failed conservative treatment after an average of 124 days, requiring subsequent surgery. Tear characteristics included 22 proximal, 10 distal, 2 midsubstance and 5 combined proximal/distal tears. The group that failed non-operative management tended to have complete tears, or tears involving both proximal and distal aspects of the UCL. Surgical management included 15 reconstructions and 3 augmented repairs. RTS occurred in 71% of the non-operative group at an average of 42 days, versus 76% of the surgical group at 180 days post-op. The primary surgery group consisted of 3 high school, 1 collegiate, and 1 national level athlete. Tear characteristics included 3 proximal, 1 proximal/distal, and 1 proximal/midsubstance/distal tear. All tears were complete. 4 underwent UCL reconstruction, and 1 received augmented repair with internal bracing. These athletes saw 100% RTS at an average of 154 days. Conclusions: Wrestlers showed high RTS rates following both nonsurgical and surgical UCL treatment; however, primary non-operative management failed in 44% of patients, particularly those with complete tears, necessitating subsequent surgery. While nonoperative treatment led to faster RTS, successful outcomes were achieved with surgical intervention, particularly reconstruction.

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