Ulnar Collateral Ligament

The ulnar collateral ligament (UCL) is located on the inside of the elbow and connects the bone of the upper arm to a bone in the forearm. The UCL is vital to maintaining elbow stability and function. This ligament may be torn as a result of injury or dislocation of the elbow, or damaged by overuse and repetitive movement and stress. If injuries do not heal properly, the elbow may become loose or unstable. Symptoms of a UCL injury include pain on the inside of the elbow, numbness, tingling, and decreased arm and elbow strength. A UCL injury is more common in athletes, especially baseball players, who use their arm constantly in a throwing motion.

Treatment for a UCL injury varies, and initial treatment may include rest, anti-inflammatory medication, and physical therapy. If symptoms persist and do not respond to conservative methods of treatment, surgery to reconstruct or repair the joint, may be necessary. Ulnar collateral ligament reconstruction is a procedure used to repair a torn or damaged UCL ligament. This procedure is commonly referred to as Tommy John surgery, named after the first baseball player to undergo the procedure.

The Ulnar Collateral Ligament Reconstruction Procedure

This procedure is performed through an incision that is made on the inside of the elbow joint. During the ulnar collateral ligament reconstruction procedure, the surgeon replaces the torn ligament with a tissue graft. In most cases of UCL injury, the ligament can be reconstructed using one of the patient's own tendons, commonly taken from the forearm, hamstring, foot, or knee. Sutures are used to secure the tendon graft in position. When the procedure has been completed, the incision is sutured closed and the elbow is bandaged and placed in a splint.

Risks of Ulnar Collateral Ligament Reconstruction

As with any surgical procedure, there are risks associated with ulnar collateral ligament reconstruction, which may include:

  • Reaction to anesthesia
  • Infection
  • Nerve or blood vessel damage

Some patients may continue to experience chronic pain and instability of the elbow, even after surgery.

Recovery and Results

The elbow is immobilized for one to two weeks after surgery. After that time, a physical therapy program will help the individual to regain strength, flexibility and range of motion. Full recovery from an ulnar collateral ligament reconstruction may take from 6 to 9 months.

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