Ulnar Collateral Ligament Surgery – Tommy John
Reconstruction treatment of the torn ulnar collateral ligament (UCL) usually requires reconstruction of the ligament with a ligament taken from the forearm. This is common with chronic instability from an acute trauma or dislocation as well as cumulative trauma from activities such as throwing.
Multiple techniques have been described to treat the torn ulnar collateral ligament. Dr. Lenarz prefers to use a tendon from the forearm which can be used without any disability or impairment. This is done as an outpatient surgery.
The initial post-operative period is focused on range of motion only and Dr. Lenarz advises his patient’s to avoid all lifting pushing and pulling with the operative arm. After an initial period of immobilization, gradual motion is begun. Failure to follow these recommendations increases the risk of the tendon being pulled away from the footprint so it is unable to heal back to the bone. After this initial period the elbow is gradually strengthened.
After the surgery, the patient will wake in the recovery room in a sling. If a “nerve block” was performed by the anesthesia doctor before the operation the arm will remain numb for 12-24 hours. This is usually done for post-operative pain control. Icing the elbow should be done liberally. This can be through the use of ice in a bag, ice packs or a circulating ice water cooler. The dressing should remain on the elbow until the first follow-up visit. Patients are asked to NOT scrub the dressing but allow water to wash over it.