hb```) $- `>bPO,VLW0ba6d.fb>4mfBs2hef`t| Thumb UCL Repair With InternalBrace Ligament Augmentation. % 02M_+ ! Thumb UCL may be repaired with Internal Brace Ligament Augmentation. The athletes that were treated with UCL repair and internal . endstream endobj 80 0 obj <>/Metadata 3 0 R/Outlines 7 0 R/PageLayout/OneColumn/Pages 77 0 R/StructTreeRoot 32 0 R/Type/Catalog>> endobj 81 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 82 0 obj <>stream hbbd```b``Z";d,d"? UCL Repair Ulnar Collateral Ligament Repair Protocol Ulnar Collateral Ligament Repair Protocol Phase I: Immediate Post-Surgical Phase (Days 1 - 21) Goals: Protect healing tissue, decrease pain and inflammation, increase scar mobility, prevent muscular atrophy Exercises: 1 i^D=)ngloqvb_3.&3e/.[A GF;'YDL65_lZ4l$!`,yv I(=wY */xZFXDI6%t0^&2L7@~DSN1& 2 0 obj endstream endobj 50 0 obj <>/Metadata 3 0 R/Pages 47 0 R/StructTreeRoot 10 0 R/Type/Catalog>> endobj 51 0 obj <>/MediaBox[0 0 612 792]/Parent 47 0 R/Resources<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 52 0 obj <>stream The UCL is the main ligament, located on the inner aspect at the base of the thumb, which stabilizes the metacarpophalangeal (MCP) joint. You are still advised to avoid gripping, grasping and twisting with your thumb. 557 0 obj <>stream UCL Repair with Internal Bracing versus UCL Reconstruction (Tommy John). UCL Repair; Young overhead athletes who sustain an injury to their medial ulnar collateral ligament (UCL) complex, isolated to the proximal or distal end of the ligament and without chronic attritional damage, may benefit from a repair rather than a reconstruction procedure.1 Reference 1. x]kF_!BBf%I(BTb%]3NrqO%)(V}nu+;jvcyiwuY[_4*j{]e>gUQU~"_e? ~Y$'h9N`haq8"% {s D)gZ2J =ky~ pP],DQgUh6*DM6`vlK ,R /"0q^p3S;LrV?-VS(6E?VAQJ@p EQQKiqLf[~vA]"`qW `!a`05I**ThsrAD8WH6SXb^h:R.?Q(oeR~R^N It was grossly incompetent and irreparable. 3 0 obj x\ms6|:6B]3~H-ST]HJHcG@>`w,@~9}}&w]|!\=|'t{_?|qcy5ca|O8%Y,npm&7& sMA-#IG71ub~ZE\@>l3c2fW?$->+zz\{M;)kO1yTS^ ^uoS7I? << /Length 5 0 R /Filter /FlateDecode >> 2 0 obj endobj >W ` 8;d3^ hb``g``Zs01G83023>"`*`+MKx.00e)zz oIB`F2Af*LoApKX@D l^" Whilst both terms are often used interchangeably, the skier's thumb refers to the cause as being acute injury. Traditional custom-fitted thumb spica orthosis In a recent cadaver study by Gil et. DOI: 10.32474/OSMOAJ.2019.03.000151. 1 0 obj Thumb UCL Repair with InternalBrace Ligament Augmentation 17,933 views Sep 6, 2018 89 Dislike Share Save Arthrex 64.2K subscribers Show more Comments are turned off. Elsevier. The UCL may be strained or torn (partially or completely) producing a weakened grasping or pinching ability of the thumb. <>>> FWfvgYpmphZsrDo\!WG-W.4BAj]Z^4~v:34a'9cl'LlL/Ka:XsWpv>{|MGK>\#(hO 213 Figure 1: The UCL repair with the internal brace inserted within the ligament. @` I8 hb``d``jd```y Restrictions: No heavy lifting greater than 0 lbs. The Orthopaedic and Fracture . Phase I (weeks 0 to 3): Splint for one week, then transition to a hinged elbow brace with gentle motion from 30 to 110 progressing to 10 to 125 at week 3. 4 0 obj Brace Week 1: posterior split at 90 degrees elbow flexion Week 2: 25-100 degrees Week 3: 15-115 degrees Interventions Soft tissue mobilization, retrograde massage for swelling Elbow PROM (as tolerated) Ice and compression Exercises Wrist AROM (all directions) immediately post-op Gripper Opposition thumb to pinky Initiate Throwing: 14-16 weeks (3.22 Months for Comparison) Bullpens: 24 Weeks (5.52 Months) Live BPs: 30-33 Weeks . Thumb UCL Repair (Internal Brace) 0-2 weeks: The postoperative dressing is removed. Elbow Ulnar Collateral Ligament (UCL) Repair Rehabilitation Protocol Kelly Holtkamp, M.D. Please fax initial evaluation and progress notes to 8153817498. On July 25, 1974, Dr Frank Jobe performed the first ulnar collateral ligament (UCL) reconstruction on Los Angeles Dodgers pitcher Tommy John ( Fig. 15 The results of this study suggest that the technique of augmented UCL repair with internal brace replicates failure strength of the . Thumb Collateral Ligament Injuries, most commonly ulnar collateral (UCL), are athletic injuries that lead to a decrease in effective thumb pinch and grasp. Subsequently, the adductor pollicis aponeurosis and extensor mechanism are identified, incised, and retracted. A longitudinal incision was made over the thumb over the metacarpophalangeal (MP) joint, the skin flaps elevated, the extensor shroud released, tendon pulled back, the adductor attachment released and the ulnar collateral ligament identified. The rise of ulnar collateral ligament reconstruction and the fall of ulnar collateral ligament repair. Above protocol adapted from Dugas and Wilk: Wilk KE, Arrigo CA, Bagwell MS, Rothermich MA, Dugas JR. Repair of the Ulnar Collateral Ligament of the Elbow: Rehabilitation Following Internal Brace Surgery. 8g14IRxEm`YH#V b6 be1Gv=*K:.;>'!y^vf%lX")z^-vr3[\)U8RnOG8+5[Y#l'^aAWgI>i];%*8jpht4%< pKV[t/ 8]oQ5JF*+zWQ61Hu^DDJT.0H>? stream 3 0 obj endobj endobj (1) See image 2. 1 0 obj No driving. At 6 to 12 weeks, begin adductor and interossei strengthening, avoiding valgus stress on thumb MCP. ( E`\Boy 'n"%QBiClMVmfzKRbq"j>Ws$ 2 0 obj endstream endobj startxref Practice this exercise for about 5 minutes. <> The brace may be removed for showering and gentle active motion exercises directed by the therapist. 0 Its many uses has helped numerous athletes return back from their injuries quicker than ever. Rehab Protocol - Thumb UCL Repair (Internal Brace Only) Dr. Broering PRECAUTIONS Full time splint use except for ROM. %PDF-1.6 % % Skier's thumb is an acute partial or complete rupture of the ulnar collateral ligament (UCL) of the thumb's metacarpophalangeal joint (MCPJ) due to a hyperabduction trauma of the thumb. Citation: Kevin E Wilk, Christopher A A, Rebekah J A. <> The rehabilitation protocol after a Ulnar Collateral Ligament Repair with Internal Brace surgery typically involves several phases. !bq\n#z0y/16C0DLP"2wn|e&35`MX2 @@^ !+~(l)2B3% !!PsEUr,!NAqYkT0(*${YNB_sYGDa|)jN!vE ` Gc^N.&/v;5$*'BDh8P}!k!2YK-|)T\{|eF_xXC'o]8 yLt)n 9f(I#]F)jQ#qbgMkZVcqhLL9{3qjU2s7)#t&"lCn'_|m+L(J:vGagJ}nab<4WGSlc.t)rT)B4"& iaS?DVn##oI&70x~o >I9XbiV`J"mE,R6,qQz"n@d,dSqd{]kE=Jxf0@.,M8^sqAGa[)^-6^`sAI@Q|p4&.grv-P_8 | 6=J). % <> The UCL provides up to 50% of the frontal plane stabilization of the Abbreviations UCL, ulnar collateral ligament; US, elbow against a valgus load.5 During the clinical evaluation, the ultrasound patient's elbow is placed under a valgus load with the elbow in vary- ing amounts of exion. %PDF-1.3 Thumb UCL Repair- Early Mobilization This protocol is intended to provide the clinician with a . endobj OSMOAJ.MS.ID.000151. Diagnosis relies upon thumb MCP radial-ulnar stress exam and MRI studies. stream Ulnar collateral ligament (UCL) injuries have significantly increased over the past few decades, especially in young throwing athletes. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> It's pretty neat to see how it has taken on a whole world of uses, including in the knee and ankle. Background: The purpose of this study is to describe our technique of thumb ulnar collateral ligament (UCL) repair with suture tape augmentation and to evaluate the short-term outcomes in our initial series of patients treated with this method of repair.Methods: Patients with minimum one-year follow up after isolated UCL repair with suture tape augmentation were contacted for clinical . endobj With the UCL repair, the surgeon will repair your native ligament and re-attach it to it's respective insertion site. V8FW hYmO8+NR)nEr'@]fuv4RUB;OfP&,!z3$Q"9#*m cLC. `eDp4)J00"2N$b\3HZhSCR hbbd```b``"'Iwh"HVqD``\y "g= ] l+ =&KU20R4@ US stream 2019 Apr;49(4):253-261. doi: 10.2519/jospt.2019.8215. 3 0 obj When the tear results in pain and instability, surgical repair offers a predictably successful outcome. 4 0 obj This design severely limits functional use of the thumb. 1-6 weeks: If the ligament is partially torn then a splint or cast is usually worn for six weeks and after its removal a programme of exercises is . Exercises: Continue all exercises listed above Elbow ROM in brace (-30 to 100) Initiate isometric elbow extension Initiate wrist isometrics 148 0 obj <>stream Walters BL, Cain EL, Emblom BA, Frantz JT, Dugas JR. 8q`Au8UnN6LW6eS4zdH 7gJRco6aDA+)vg+|Pn.Tz8W>dt+O)1L the thumb. The new procedure involves repairing the damaged ligament and reinforcing it with a collagen-coated fiber tape in contrast with the traditional UCL reconstruction that involves drilling tunnels in the bone and using a graft from a tendon in your arm or leg. x[k_!l&.]>d!EMeK-y2+^]=2>P?tq:LzN=VA5X\SWZiu*zzmjN5Ru= QRN>`:N}x^_o?y,A\C/WiNQu)Ftz#CBk_QoTk-)WUT^\QBOSRM]8zb'ai+Zd|oc5&hYGkC(KURumUHkf]*A+KU"1OZ&AUh )M4p0m|iMLku=uJ 4 0 obj %%EOF stream (} oA%Yv:JzFQA 0X"5o A%U- MLZ;?3%RO8?DnQN['y]{_5%x@iSt>K2! c5(Ly%CDer,ZbE+ImgILF cy9 The UCL repair with Internal Brace was developed as a faster alternative to a full UCL reconstruction. Steven Shin, MD, treats elite athletes in his clinic, but you don't have to play for a professional team to benefit from his groundbreaking technique for treating thumb ulnar collateral ligament (UCL) injuries.. For injuries that need more than a cast, internal brace augmentation gives better and much faster results than conventional surgery, according to Shin, executive vice chair of Cedars . 2 WEEKS (1st Visit) Fit with custom hand based thumb spica splint (Please allow thumb IPJ motion) OT INSTRUCTIONS - Ok to work on wrist, CMP, IPJ motion, & scar massage They demonstrated a significantly greater resistance to gapping with valgus stress with the UCL repair with internal brace (mean SD, 0.35 0.16 mm) compared to UCL reconstruction (0.53 0.23 mm). Resource Type: Surgical Technique Animations. At the ulnar aspect of the thumb MCP joint, a longitudinal midaxial incision is made. TREATMENT: Treatment consists of either a period of splintage or if completely torn,a repair of the ligament with an operation. endobj Rehabilitation following UCL repair with internal brace is accelerated by comparison to Tommy John Surgery. *`]hgTTS:MV{gXS&K|-3m Epub 2019 Mar 12. 1 0 obj Jsx cx=[wOGvu UV]QEMtejL11eO2\5~B*q>vvcu9]dtUbqjNU{ 1 0 obj <> <> Thumb UCL Repair With InternalBrace Ligament Augmentation What's New in Orthopedics 207K subscribers Subscribe 24 Save 3.8K views 1 year ago .more .more Notice Age-restricted video. PubMed PMID: 30862273. ,.l(\r @48 dJ^ %$HU 44HK[Y.D;2d8A1 d9\Imog|G|L8p,b}- BT"/q[[%p4)dl0( TOO#]x~0zKGeyk7-Zb!Z]#_@As r1'B04Lq0tS>Yf0lUQ0z.?9M7eCe[4^orMi|yF`8j_z\p=-g:I}^\RVDw*w They also showed that internal brace repair performs similarly to the docking reconstruction technique . Joint destruction compresses nerve roots, resulting in pain, paresthesia, sensory loss, dysautonomia, and spasticity. sHSlC:">)n2oAGV?vtE6f?r83bSXk8[~@t(zQXA>)V|@)} 1&%_qU}VuA (nKS"(;VB| >`UVtXb#xEpF,Z%ZX["'XP % Reference Number: AN1-00264-en-US | Version: C. Related Pages. The internalbrace is the underpinning of the repair procedure. y!my6gvF-~g,8\'N&p[t|x0 u0vNzSKjZ*C(hZ}szu9`3_?=/ . &Dam[L1-J" iiBUq[{0R 3xVoEouUja,Jd> k '! *XM qD#qHU vr@^zo+Uwe#-`0XLij1 H00:GCp#r x 92 0 obj <>stream ]rav?4V&%n\(blvdf)TUL"Q+zaH$!EWq,0S4o~!dAf36J5/JqR^)jUx}2}`4vT.5l;c6gA>< MVSxwkHW *LLGrj iBy+9,[Ld~!VpQ[/zT-k.x #M'Ismi>uw a8G PeT{qo| R7RP2rAK(; 0 Orthop & Spo Med Op Acc J 3(1)- 2019. &AaBCZKqi =ip;!%RqhH%1[6[8]fwFxw l4)W%5 %PDF-1.6 % EXHIBIT(S) - D (Motion #1) EXHIBIT D - Verified Bill of Particulas and Responses to Various Demands Redacted per 22 NYCRR - EXHIBIT D - Verified Bill of Particulas and Responses to Various Demands Redacted February 09, 2023. endstream endobj 503 0 obj <. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> endstream endobj 111 0 obj <>/Metadata 5 0 R/Outlines 9 0 R/PageLayout/OneColumn/Pages 108 0 R/StructTreeRoot 16 0 R/Type/Catalog>> endobj 112 0 obj <>/ProcSet[/PDF/Text]>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 113 0 obj <>stream endobj &H+JIKv)ATPJ};CH 1 Major components of the TFCC are the articular disc (AD), meniscus homolog, radioulnar ligaments, and extensor carpi . <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> General time frames are given for reference to the average, but individual patients will progress at different rates depending on their age, There was gross instability of the ulnar collateral . . A bP .a+ZY^tL3ab`y7*n&++c |C&K 0g-Pf4/.B{s. 128 0 obj <>stream %%EOF : Keep post-operative dressing clean, dry, and in place Keep hand elevated above the level of your heart May use hand for very light activities of daily living, such as eating, writing, typing, getting dressed, and brushing teeth Day 7-14: 104 0 obj <>/Filter/FlateDecode/ID[<33B8DE36AB984B418169C7A4E24F203B><19F8EE0B324BFE44BA1CA95B759557F5>]/Index[79 50]/Info 78 0 R/Length 117/Prev 108309/Root 80 0 R/Size 129/Type/XRef/W[1 3 1]>>stream endobj J Orthop Sports Phys Ther. endstream endobj startxref hV]OF+B^ Educate the patient on anti edema management. The length of each phase varies depending on each patient and depends on tissue healing and progression. At 10 to 12 weeks, return to . your repair for 4 more weeks. 2 0 obj <> ULNAR COLLATERAL LIGAMENT REPAIR with INTERNAL BRACE Postop protocol for Daniel Myer, M.D. K\'~8_c3(rKC-,9/$&nd#{:+H>>*/yGG`b9.`\z. %PDF-1.3 Late effect of dislocation (nonspecific) (905.6) Repair lateral collateral ligament, elbow, with local tissue (24343) Repair lateral collateral ligament, elbow, with tendon graft, including graft harvest (24344) Repair medial collateral ligament, elbow, with local tissue (24345) Repair medial collateral . x[[oF~70/ 8m6EMc/El%{JaeQlQCwnz5fy3iboob9jV Background:Thumb ulnar collateral ligament (UCL) tears are common in competitive athletes. hb```-B ce`a}`QJ se fpXF5#m-2q#M=T.Q,A%@ -& B@P xIq;8W2K0e7oS^s&3w&iO'i`4a` 132 0 obj <>/Filter/FlateDecode/ID[<74EC21535A719E4081B6460A7EF86336>]/Index[110 39]/Info 109 0 R/Length 107/Prev 88703/Root 111 0 R/Size 149/Type/XRef/W[1 3 1]>>stream The goal is to endobj <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> << /Length 5 0 R /Filter /FlateDecode >> q | Find, read and cite all the research you . 4 0 obj K`d:V0!QGXCor&J;#Z?='lH3cy?_pOk0qWR_heBU] u)dh5Q :e16&\H11}8 1AE Qf>`?SLXSu {q?u,:g@l2;1FhCSTV9}WKH}[agS~?P3{47*c:lg3l#`vLx}{*_Q]}O)D5*wX[PB{A8k1GtM{@onC 0Ggtz=CiZM.sVLCbi`JC3T)q7]tZ4c^l&XkC~?G.9J7 ]sO0h5_K]@GB[q[Vg"$(MjTy &H<0LElM0i""(P f4G0 H2a`70&E00v$`?W r Thumb UCL Repair- Conservative This protocol is intended to provide the clinician with a guideline for the postoperative rehabilitation course of a patient who has undergone thumb UCL reconstruction/repair. Return to Play in Athletes After Thumb Ulnar Collateral Ligament Repair With Suture Tape Augmentation - Daniel B. Gibbs, Steven S. Shin, 2020 Finger and hand range of motion: maintain AROM and PROM 3 0 obj Injuries to the ulnar collateral ligament of the thumb metacarpophalangeal joint (gamekeeper's thumb). Dr. Allen Thumb UCL Reconstruction Rehabilitation Protocol Phase I: Immediate Post-Op (Weeks 0-2) . %%EOF Thumb strengthening: Pick up small objects, such as paper clips, pencils, and coins, using your thumb and each of your other fingers, one at a time. @B 8XqhPTU&] ia$A{B;*QX% ]p7L`k?g.G{"z)UU(YY%y\*.ic-PtB *qjbeBA1~ Duration: 01:52. Postoperative Rehabilitation 7-10 days postop The bulky compressive dressing is removed. 0 To date, no literat. The anti edema management will continue for several weeks. Hrut LF?L . hWmo6+KI A ;WcIZ2LVaj%%u70y{l800`$p(AI6GBNP8S,CCrJcr\) '_'n}Zj #:qdAa C;wB.Cx/mu 3hf_u*m"ZeD!\4' (l{aef"];c4#P9G4e't\Y1AM)DmgT?G -rG" ojqQPy3e8AcR:N~ N :#1YGokb &h(TA(VG[H}FQ. thumb ucl repair with internal brace protocol. !-twF)rm16:M.J r]Sc]Oi~ This animation demonstrates repair of the ulnar collateral ligament of the thumb with the InternalBrace ligament augmentation procedure. stream %PDF-1.7 These tears often occur as a result of a radially directed force on an extended thumb. Dressing changed at 7-10 days after surgery Week 2 endobj REHABILITATION PROTOCOL: ULNAR COLLATERAL LIGAMENT REPAIR/RECONSTRUCTION RADIAL COLLATERAL LIGAMENT REPAIR/RECONSTRUCTION THUMB MP JOINT WITH INTERNAL BRACE A. J. Mencias, M.D. 15 -17,19 Therefore, UCL reconstruction has become a common procedure to address UCL insufficiency in adolescent, collegiate, and professional throwers. Hand and Wrist hbbd```b``3@$S=d`6;dq7.`.df`\0LE-`6H rlg4okAdaHMH Ligament / Volar Plate CPT Codes. At 6 weeks after surgery, the supportive brace should be worn with activities, but you may do light tasks, such as typing without it. % Volume 3 ssue 1 Coprig Kevin ilk et al. 49 0 obj <> endobj SYMPTOMS: The thumb may be swollen, bruised and painful. PDF | Background: Combined injuries of ipsilateral wrist and elbow joints are rare in clinical practice, characterized by multiple joint dislocations. 1. Z\m>~?)I|%X$;-5X&gV+Kms?XRC5%x_ui6q |KdeW7mQUY3s`NB) =gY|6:51c_t]]MixSTB Thumb UCL Repair and Reconstruction With Internal Brace Ligament Augmentation Repair Ulnar collateral ligament (UCL) tears of the thumb are common injuries. Abstract and Figures Acute rupture of the ulnar collateral ligament (UCL) of the thumb - also known as 'skier's thumb' - is a common injury which may cause long-term complications if. <>/Metadata 554 0 R/ViewerPreferences 555 0 R>> r e c . !V!B;nkGL#_cz5asG) 0<>;Qm4P]3@41oJ5i~o;sJvQv9f r4A-C -Z]>T]Fo Rehabilitation Following UCL Repair with Internal Brace. %PDF-1.7 %PDF-1.6 % endstream endobj startxref 4 0 obj The InternalBrace Splint: A hand-based thumb spica splint with IP free (for thumb) or Safe Position Splint (for other digits) with medial or lateral stops on the opposite site of the repaired ligament is constructed to be worn between exercises and at night. This internal brace surgery was developed by surgical company Arthrex. Open your fingers to stretch the rubber band. Phone: 574.247.9441 Fax: 574.247.9442 www.sbortho.com REHABILITATION PROTOCOL: THUMB UCL/RCL REPAIR SAM FULLER, M.D. Postoperative protocol. -Hand based thumb spica brace (comfort cool) . The ulnar collateral ligament (UCL) does not play a large role in elbow stability for most activities of daily living, but it does undergo tremendous stresses with overhead throwing and is susceptible to injury in overhead athletes. Phase I - Maximum Protection: 0 to 7 Days: Immobilization in posterior splint at 60-90 of elbow flexion . Acute UCL tears: Thumb spica splint/cast for up to 4 weeks, interphalangeal joint free. <> %PDF-1.7 533 0 obj <>/Filter/FlateDecode/ID[<6B9C59BBC5B61A4384B9FC807F8AE13A><1E4DC5E074430D4EA5AA205F41080698>]/Index[502 56]/Info 501 0 R/Length 138/Prev 267459/Root 503 0 R/Size 558/Type/XRef/W[1 3 1]>>stream In a recent laboratory study conducted by the Arthrex Research Department using cadaver specimens, the thumb UCL with internal brace was four times stronger than the standard repair with suture alone. 0 ?3U,a_~`XRUWcQT2r?B73pgry.v3}w/2\Fz?6-SHK PXUU9:!$\@j)b;}r% /5 V5uz @ TY}]7KX75F1"3#TZLY|A/+{gc_?olhfGmHwiiB%"=CH$ai-`75 gdkZ_ /&E-{BpR`buqyxw{y1E2vzy!`reY,$OcvCnbv_]pyu_//~0]8~t2Vj-/U 14 Days Postoperative Do NOT remove the surgical bandage. Revision Date: 10/29/2021. ["BIA+ryv_cNaICaNJ!E.|dXTp3g@9< HTxS 502 0 obj <> endobj Thumb Ulnar Collateral Ligament Repair Post-Operative Protocol Days 0- until first Post-Op Apt. Elevate, ice and modalities to reduce pain and inflammation . 1). This technique involves the reattachment of the ligaments to the bone using FiberWire. Right after the surgery, the elbow is secured in a brace at a 60- to 90-degree angle. Clinical Orthopeadic Rehabilitation: A Team Approach E-Book, 4th Edition. 2 0 obj The primary goal of this surgery is to enhance elbow joint stability while the ligament is healing and to allow earlier return to sport after UCL reconstruction. We describe the surgical technique of suture tape augmentation for thumb UCL repair. Shoulder isometrics (no shoulder internal rotation) Biceps isometrics . endobj Brotzman, S. & Novotny, S. (2018). At 4 to 6 weeks, removable thumb spica splint, and protected range-of-motion exercises. The newer repair procedure utilizes internalbrace, which comprises high-strength fibertape suture, to reenforce and protect the ligament while it is healing, and provide additional protection during throwing activities.