The ulnar collateral ligament (UCL) is located on the inside of the elbow, and connects the upper arm bone to the forearm bone. Injuries to the UCL occur from repetitive stress to the elbow, or from trauma. UCL injuries are uncommon in the general population, but frequent among athletes who participate in throwing sports like baseball.
Ulnar collateral ligament reconstruction is often called “Tommy John surgery” after the famous baseball pitcher who was the first to undergo the procedure. The surgeon makes an incision in the elbow and then drills holes in the humerus and the ulna. A tendon taken from the patient’s forearm, leg, or opposite elbow is then woven through the holes and anchored to the bone. The external wound is then closed with sutures. Surgery is designed to restore stability of the elbow.
Who is a candidate?
Candidates for ulnar collateral ligament reconstruction typically have exhausted nonsurgical treatment options.
Who is not a candidate?
Patients who have not yet exhausted nonsurgical treatment options for UCL injuries are not candidates for ulnar collateral ligament reconstruction.
Like other surgeries, shoulder resurfacing requires a complete physical examination with your primary care provider and/or orthopedic surgeon prior to surgery. You should inform your orthopedic surgeon of any medications or supplements you take, and comply with general surgery procedures such as preoperative blood testing and possible cessation of smoking or use of pain relievers and anti-inflammatory drugs one week prior to surgery. You may need to stop taking blood thinner medication if you are on a regular dose of drugs such as Warfarin (or other blood thinners). You will likely be asked to stop eating or drinking the night before surgery.
As an outpatient procedure, ulnar nerve release typically requires no overnight hospital stay. Keeping your arm elevated will reduce swelling for the first few days post-surgery. You will most likely need to wear a splint for the first few weeks after the operation. Your physician may give you at-home exercises to help regain strength and motion in your arm.
As with any surgery, there are risks of complications related to bleeding, nerve and blood vessel damage, and infection. Long term complications include chronic pain with throwing and chronic instability of the elbow.
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