Eighty-three athletes with medial elbow instability underwent reconstruction of the anterior band of the ulnar collateral ligament with a muscle-splitting approach without transposition of the ulnar nerve. The purposes of this study were to describe postoperative neurologic outcomes in all 83 athletes and to describe the 2-year follow-up in 33 athletes. Postoperatively, 5% of this group had transient ulnar nerve symptoms, all of which resolved with nonoperative management. There were no reoperations for nerve dysfunction and no permanent nerve problems. At 2-to 4-year follow-ups, 93% of the highly competitive athletes who had not had a prior surgical procedure had an excellent result. All athletes, regardless of whether they had a prior procedure, were able to return to their sport. These surgical modifications to the ulnar collateral ligament reconstruction yielded a decreased postoperative complication rate and improved outcomes compared with the results of prior procedures.
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