Trends in Ulnar Collateral Ligament Injuries and Surgery From 2010 to 2019: An Analysis of a National Medical Claims Database.

Background: Ulnar collateral ligament (UCL) injuries have been on the rise for the past 3 decades. Current epidemiological studies on the incidence of UCL injuries have been limited to state or regional data. Purpose: To utilize a large national claims database to determine the rates of UCL injuries and UCL surgical procedures over the past decade (2010-2019) and whether there has been a change in UCL surgical procedure patterns in the United States. Study Design: Descriptive epidemiology study. Methods: The PearlDiver patient claims database was used to identify UCL injuries occurring from 2010 and 2019 that were sustained by male patients between 10 and 34 years of age. The study cohort was divided into 5 age groups (10-14, 15-19, 20-24, 25-29, and 30-34 years). Primary outcomes included the number of patients in each age group who sustained a UCL injury, the number of patients in each age group who underwent surgery, and the mean time from injury to surgery. Results: A total of 19,348 UCL injuries occurred between 2010 and 2019, and 13% required a surgical intervention. Most of the injuries (54%) occurred in the 15- to 19-year group. Patients in the 20- to 24-year group were more likely to undergo surgery versus the 15- to 19-year group. Results demonstrated a trend toward delayed surgical interventions in patients in the 20- to 24-year group in the latter part of the decade. Conclusion: Data suggested that male patients <20 years account for the majority of UCL injuries, while male patients aged between 20 and 24 years are most likely to undergo surgery. Despite a number of targeted injury-prevention strategies and rule changes in sports, the UCL injury rate remained high. Therefore, there is a clear and present need to continue to develop UCL injury-prevention strategies for the younger population.