==== Front Orthop J Sports MedOrthop J Sports MedOJSspojsOrthopaedic Journal of Sports Medicine2325-9671SAGE Publications Sage CA: Los Angeles, CA 10.1177/2325967118S0008410.1177_2325967118S00084ArticleUlnar Collateral Ligament Repair with Internal Brace Augmentation in Amateur Overhead Throwing Athletes Dugas Jeffrey R. MD1Looze Christopher A. MD2Jones Christopher Michael MD3Walters Brian L. MD4Rothermich Marcus A. MD2Emblom Benton A. MD1Fleisig Glenn S. PhD5Aune Kyle MPH5Cain E. Lyle MD11 Andrews Sports Medicine & Orthopaedic Center, Birmingham, AL, USA2 ASMI/Trinity/Lemak Sports Medicine Program, Birmingham, AL, USA3 University of South Alabama, Mobile, AL, USA4 American Sports Medicine Institute (St. Vincent’s) Program, Birmingham, AL, USA5 American Sports Medicine Institute, Birmingham, AL, USA27 7 2018 7 2018 6 7 suppl4 2018 AOSSM Annual Meeting Abstracts2325967118S00084© The Author(s) 20182018SAGE PublicationsThis open-access article is published and distributed under the Creative Commons Attribution - NonCommercial - No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits the noncommercial use, distribution, and reproduction of the article in any medium, provided the original author and source are credited. You may not alter, transform, or build upon this article without the permission of the Author(s). For article reuse guidelines, please visit SAGE’s website at http://www.sagepub.com/journals-permissions.Objectives: There has been a renewed interest in UCL repair in overhead athletes. This is largely due to greater understanding of UCL pathology, improvement in fixation technology and the extensive rehab required to return from UCL reconstruction. Initial data regarding UCL repair in overhead athletes was poor and therefore UCL repair was largely abandoned in favor of reconstruction. However, recent literature examining UCL repair with anchor only fixation demonstrated an excellent rate of return to play, reduced time to return to play and a low complication rate. Based on this promising data, we have developed a novel technique of UCL repair with internal brace augmentation that we have used in overhead throwing athletes. We performed a prospective study evaluating the outcomes of this procedure with respect to return to play, time to return to play, functional outcome score and complications. Methods: Overhead athletes undergoing UCL repair with internal brace augmentation were prospectively followed for a minimum of one year. Patients were carefully selected from those who would traditionally be considered for UCL reconstruction. Initially, patients were considered if they had an avulsion of the UCL with otherwise healthy UCL tissue and had a vested interest in shortened rehab. As the study progressed, interest in shortened rehab became a less stringent criteria. Demographic and operative data were collected at the time surgery. This data was compiled for both desciption and comparison between subgroups. Patients were then contacted 1 year postoperatively and assessed for return to play, time to return to play and KJOC scores. Complications were documented and patients having complications were detailed. Results: 66 overhead athletes underwent UCL repair with internal brace augmentation during the study period. 8 were lost to follow up, leaving 58 athletes included in the study. Average age at the time of surgery was 17.9 years old. There were 43 baseball pitchers, 8 baseball position players, 4 softball players, 2 football quaterbacks, and 1 javelin thrower. 96% (54/56) of those who desired to return to the same or higher level of competition were able to do so at an average time of 6.1 months (range 3.2-12 months). 65% of these were able to return in less than 6 months. Many of those who took longer than 6 months did so due to timing within the season. Average KJOC score was 90.2 at 1-year follow-up. 3 patients required return to the operating room, 2 of which were eventually able to return to their previous level of play. There was 1 late failure over 3 years from the index procedure. Comparative subgroup data is presented in table 1. Conclusion: UCL repair with internal brace augmentation is a viable option for overhead throwers with selected UCL pathology who wish to return to sport in a shorter time frame than allowed by traditional UCL reconstruction. Comparative Analysis of Subgroups. Time to return to N KJOC P-value play (Months) P-value Location of tear    Distal 34 89.6 6.00    Proximal 24 90.6 P=0.71 6.19 P=0.74 Severity of tear    Partial 35 89.5 6.14    Complete 23 91.4 P=0.51 6.08 P=0.86 Ulnar Nerve Transposition    UNT performed 32 90.9 6.40    UNT not performed 26 89.4 P=0.17 5.75 P=0.16 Overall 58 90.2 6.13 edited-statecorrected-proof