title: Does Geographic Location Matter on the Prevalence of Ulnar Collateral Ligament Reconstruction in Collegiate Baseball Pitchers?
abstract: BACKGROUND
  There has been a significant amount of research in the prevention of throwing injuries. However, one area of research that is lacking is geographic location of play. Warm climates may permit year-round play and increased exposure to throwing arm injury risk.
  
  
  OBJECTIVE
  (1) Pitchers from southern institutions would have greater rates of ulnar collateral ligament reconstruction (UCL-R) compared with pitchers from northern institutions. (2) Pitchers originating from high school teams in warm weather states would have a greater risk of undergoing UCL-R while in college.
  
  
  METHODS
  Descriptive epidemiological study.
  
  
  METHODS
  This study was completed by reviewing publicly obtained records of male collegiate baseball players during the 2008 through 2014 seasons. Data were accessed through online search engines, online baseball media guides, and school websites.
  
  
  RESULTS
  A total of 5315 player-years and 2575 pitcher-years were identified. Fifty-eight UCL-R cases were found in collegiate pitchers, 40 of which occurred in the Southeastern Conference (SEC) and 18 in the Big Ten. More injuries (36/58) occurred in pitchers who participated in high school baseball in southern states as compared with northern states (22/58), regardless of location of collegiate participation (χ(2) = 28.8, P < .05). The injury rate for pitchers who participated in high school baseball in southern states was 25.3 per 1000 player-years versus 19.1 per 1000 player-years in northern states, with a risk ratio of 1.32 (χ(2) = 0.89, P = .35). The injury rate for the SEC versus Big Ten pitchers was 13.3 per 1000 player-years versus 7.8 per 1000 player-years, with a risk ratio of 1.71 (χ(2) = 1.45, P = .23).
  
  
  CONCLUSIONS
  There is a greater likelihood of undergoing UCL-R in the SEC compared with the Big Ten. There is also an increased risk for UCL-R for pitchers who played high school baseball in southern states versus northern states, irrespective of collegiate play location.
  
  
  CONCLUSIONS
  Pitchers originating from high schools in a warm weather climate may be more likely to undergo UCL-R.
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida, USA.
authors.forename: Jason L
authors.initials: JL
authors.lastname: Zaremski
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida, USA.
authors.forename: MaryBeth
authors.initials: M
authors.lastname: Horodyski
authors.affiliation: Department of Community Health and Family Medicine, University of Florida, Gainesville, Florida, USA.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Donlan
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida, USA.
authors.forename: Sonya Tang
authors.initials: ST
authors.lastname: Brisbane
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida, USA.
authors.forename: Kevin W
authors.initials: KW
authors.lastname: Farmer
keywords: baseball; elbow; reconstruction; throwing; ulnar collateral ligament