Abstract
Overhead throwing subjects the shoulder and elbow to substantial stresses, resulting
in unique injury patterns that need to be recognized to allow appropriate treatment
and return to sport. At the elbow, the ulnar collateral ligament (UCL) is the primary
static restraint to valgus stress and the most commonly injured structure. UCL reconstruction
is the most frequent surgical procedure in throwers and may be performed along with
ulnar nerve transposition and flexor-pronator mass procedures. Posteromedial impingement
and valgus extension overload syndrome are related entities that result in intra-articular
pathology, such as osteophytes or bodies lodged within the olecranon fossa, also warranting
excision at the time of UCL reconstruction. Shoulder injuries involve the rotator
cuff (partial-thickness articular-sided tear), labrum (superior anteroposterior labral
tear), and capsule (glenohumeral internal rotation deficit). Surgical options such
as cuff repair, labral debridement or repair, and capsular release or tightening therefore
target these structures.
Keywords throwing - labral tear - rotator cuff tear - ulnar collateral ligament reconstruction
