UCL ruptures are classified by severity and cause:

1. Partial rupture: The ligament is partially damaged, leading to mild to moderate symptoms.
2. Complete rupture: The ligament is completely severed, leading to significant instability.
3. Acute rupture: Sudden injury due to a strong load or trauma.
4. Chronic rupture: Slow wear of the ligament due to repeated stresses.
5. Accompanying injuries: Damage to adjacent structures such as muscles or tendons often occurs.

The causes of a UCL rupture are varied and can include both traumatic and overload-related factors:

- Acute causes:

- Sudden stress on the elbow, for example, due to a fall or a jerky movement.

- Direct injuries, such as in contact sports.

- Chronic causes:

- Repeated overhead movements that stress the ligament over a longer period.

- Microtrauma from throwing sports like baseball, handball, or javelin throw.

- Contributing factors:

- Anatomical misalignments in the elbow joint.

- Weaknesses in the surrounding musculature that stabilize the joint less.

The symptoms vary depending on the severity of the rupture, but typically include:

• Pain: Often localized on the inside of the elbow, especially under stress.
• Instability: A feeling of "giving way" or uncertainty in the elbow joint.
• Limited mobility: Difficulty in extending or bending the arm.
• Swelling and tenderness: Often in the area of the medial elbow.
• Popping sound: Often heard in acute ruptures.
• Loss of performance: Reduced strength and precision in throwing movements.

The diagnosis is made through a combination of medical history, clinical examination, and imaging techniques:

- Medical history:

- The doctor inquires about the circumstances of the injury, the nature of the symptoms, and athletic activities.

- Physical examination:

- Special tests such as the valgus stress test or the moving valgus stress test to check ligament stability.

- Palpation of the medial elbow for tenderness.

- Imaging:

- MRI: Detailed depiction of the ligament and any accompanying injuries.

- Ultrasound: Detection of ligament injuries and fluid accumulations.

- X-ray: To rule out bone injuries or accompanying changes.

Conservative Therapy

For partial tears or minor symptoms, non-operative treatment is often sufficient:

• Immobilization: Use of a brace or splint to stabilize the elbow.
• Medication Therapy:
  • NSAIDs: For pain relief and anti-inflammatory effects.
• Physiotherapy:
  • Exercises to strengthen the elbow muscles and improve joint stability.
  • Functional movement exercises to gradually load the arm.
• Injections:
  • Platelet-Rich Plasma (PRP) to promote tissue regeneration.

Surgical Therapy

For complete tears or persistent instability, surgery is required:

• Ligament Reconstruction: Replacing the torn ligament with a graft, often using the body's own tendons (e.g., palmaris tendon).
• Tommy John Surgery: A specific technique for UCL reconstruction, particularly used in athletes.
• Arthroscopic Procedures: Minimally invasive procedures with faster rehabilitation.

The following measures are suitable for preventing UCL ruptures and supporting recovery:

1. Strengthening the muscles: Targeted training of the shoulder, arm, and elbow muscles.
2. Warming up and stretching: Preparing the joint for athletic stress.
3. Load management: Avoiding excessive repetitions of overhead movements, especially in young athletes.
4. Ergonomic movement patterns: Improving throwing technique to reduce stress.
5. Regular check-ups: Early detection and treatment of overload symptoms.