PhD defence R.J. (Rik) Molenaars

Brief summary:

This thesis provides a deeper appreciation of the art of throwing (fast) and contributes to our understanding of the pathogenesis and prevention of athletic elbow injuries by exploring various components of the history, workup, and pathoanatomy of ulnar collateral ligament injuries of the elbow in overhead athletes. In the first part, the implications of the near-maximum loading of the UCL with baseball pitching are outlined, drawing out the history of UCL injury and introducing the 'epidemic' of reconstructive surgeries performed in (young) baseball pitchers to date in the United States and Japan. In the second part, various aspects of the clinical workup of UCL injuries are explored, including the clinical value of the athlete's sensation of a "pop" at the time of injury (does this salient anamnestic finding suggest significant UCL injury in throwing athletes?) and the usefulness of determining medial elbow joint opening with stress radiographs in throwing athletes with medial elbow pain. The final part of this thesis focuses on the pathoanatomy of UCL injury and reconstructive surgery of the elbow and forearm, including a descriptive analysis of injury patterns to the anterior bundle of the UCL based on a single-surgeon cohort undergoing UCL reconstruction.