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Ulnar Collateral Ligament (UCL) Repair with Internal Brace
UCL repair with an internal brace is a surgery that involves the use of collagen-coated tape (internal brace) surgically placed at the site of the damaged UCL ligaments. It provides better resistant and a faster recovery compared to traditional reconstruction surgery that involves the use of graft tissue from your body.
Anatomy
The ulnar collateral ligament (UCL), also called the medial collateral ligament, is located on the inside of the elbow and connects the ulna bone to the humerus bone. It is one of the main stabilizing ligaments in the elbow, especially with overhead activities such as throwing and pitching.
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Ulnar Collateral Ligament (UCL) Injuries
UCL injuries are usually caused by repetitive overhead throwing such as in baseball. The stress of repeated throwing on the elbow causes microscopic tissue tears and inflammation. With continued repetition, the UCL can tear preventing the athlete from throwing at significant speed. If untreated, it can end an athlete’s professional career.
UCL injury may also be caused by direct trauma such as with a fall, car accident, or work injury. Other causes include any activity that requires repetitive overhead motion of the arm such as tennis, pitching sports, fencing, and painting.
Indications for UCL Repair with Internal Brace
UCL repair with an internal brace is indicated for the fast recovery of UCL injuries in athletes. It restores a full range of motion in the elbow for the athlete to return quickly back to sports.
Preparing for the Surgery
- Your doctor will assess the symptoms and take a medical history.
- Physical examination of your elbow will be performed. Imaging studies such as X-ray, MRI, or CT-scan will be ordered.
- Fluoroscopy may be ordered to help diagnose the injury.
- Talk to your doctor about the medicines you are taking prior to the procedure. Inform your doctor if you are allergic to any medicines or anesthesia.
- Be prepared for an overnight stay at the hospital and arrange for someone to drive you home the next day.
Procedure of UCL Repair with Internal Brace
The surgery involves the following steps:
- You are positioned to lie on your back (supine position)
- You may be given general and regional anesthesia.
- An incision is made near the medial epicondyle of your elbow towards the UCL ligaments.
- Your surgeon performs debridement of damaged tissues.
- Suture anchors are placed at the point of origin of the ligament.
- A collagen-coated (internal brace) tape is placed.
- Care is taken to avoid damage to nerves.
- The internal brace is attached to the bone surfaces with special sutures.
- The incision is closed with sutures and covered with sterile dressings.
Recovery after Surgery
Your doctor will prescribe pain medicines as needed. Your elbow is supported with a sling for about 6 weeks. Your physical therapist will teach specific exercises to help you recover sooner.
Risks and Complications
Complications are rare but can include:
- Infection
- Limited range of motion
- Nerve damage
- Elbow instability
Frequently Asked Questions
What is UCL repair with an internal brace?
UCL repair with an internal brace is a surgery that uses collagen-coated tape (the internal brace) placed at the site of the damaged ulnar collateral ligament on the inside of the elbow. It provides greater resistance and a faster recovery than traditional reconstruction surgery that uses a tendon graft from your own body.
What causes UCL injuries?
UCL injuries are usually caused by repetitive overhead throwing, such as in baseball, where repeated stress creates microscopic tears and inflammation that can progress to a full tear. They can also result from direct trauma like a fall or car accident, or from repetitive overhead activities such as tennis, fencing, and painting.
Who is a good candidate for UCL repair with an internal brace?
This procedure is especially indicated for athletes who need a fast recovery from a UCL injury. It restores full range of motion in the elbow so the athlete can return to sports quickly.
How is UCL repair with an internal brace performed?
Under general and regional anesthesia, Dr. Luo makes an incision near the medial epicondyle, removes damaged tissue, and places suture anchors at the ligament’s origin. The collagen-coated internal brace tape is then attached to the bone surfaces with special sutures, with care taken to protect nearby nerves.
What is recovery like after this procedure?
You may stay in the hospital overnight, and your elbow is supported with a sling for about 6 weeks. A physical therapist will teach specific exercises to help you recover sooner. Complications are rare but can include infection, limited range of motion, nerve damage, and elbow instability.
Randy Y. Luo, MD, MBA
Board Certified Orthopedic Surgeon
Hand & Upper Extremity Specialist