02M_+ ! Thumb MCP UCL InjuriesHow Much Do We Need to Immobilize? - BraceLab %%EOF r e c . Phone: 574.247.9441 Fax: 574.247.9442 www.sbortho.com REHABILITATION PROTOCOL: THUMB UCL/RCL REPAIR SAM FULLER, M.D. <> General time frames are given for reference to the average, but individual patients will progress at different rates depending on their age, A UCL repair with internal brace is reserved for use in cases of partial or complete tears at the origin or insertion of the UCL with good ligament tissue and low-grade mid-substance partial UCL tears [10]. stream 15 The results of this study suggest that the technique of augmented UCL repair with internal brace replicates failure strength of the . |C&K 0g-Pf4/.B{s. Citation: Kevin E Wilk, Christopher A A, Rebekah J A. 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 We describe the surgical technique of suture tape augmentation for thumb UCL repair. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 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. Repair of the Ulnar Collateral Ligament of the Elbow: Rehabilitation Edema control is initiated with a light compression dressing. Elbow Ulnar Collateral Ligament Repair with InternalBrace 1 i^D=)ngloqvb_3.&3e/.[A GF;'YDL65_lZ4l$!`,yv I(=wY */xZFXDI6%t0^&2L7@~DSN1& stream PDF Ulnar Collateral Ligament (UCL) Injury to the Thumb thumb ucl repair with internal brace protocol. . endobj PDF Brandon J. Erickson, MD Mackenzie Lindeman, ATC 176 3 - Rothman Ortho The repeated microtrauma is a result of a lack of muscle protection and destroys cartilage, ligaments, and disc spaces, leading to vertebrae destruction, joint instability, subluxation, and dislocation. Ultrasound-Assisted Assessment of Medial Elbow Stability 3BRKpw.4/Y. Thumb UCL Repair- Early Mobilization This protocol is intended to provide the clinician with a . endobj The brace may be removed for showering and gentle active motion exercises directed by the therapist. A longitudinal incision was made over the thumb over the metacarpophalangeal (MP) joint, the skin flaps elevated, the extensor shroud released, tendon pulled back, the adductor attachment released and the ulnar collateral ligament identified. PDF Thumb Ulnar Collateral Ligament Repair Post-Operative Protocol POST-OPERATIVE WEEK 2. The internalbrace is the underpinning of the repair procedure. It was grossly incompetent and irreparable. FWfvgYpmphZsrDo\!WG-W.4BAj]Z^4~v:34a'9cl'LlL/Ka:XsWpv>{|MGK>\#(hO J Orthop Sports Phys Ther. Thumb UCL Repair (Internal Brace) 0-2 weeks: The postoperative dressing is removed. hbbd```b``"'Iwh"HVqD``\y "g= ] l+ =&KU20R4@ US <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Its many uses has helped numerous athletes return back from their injuries quicker than ever. aY_dM\\Kq[SZ 6| F8$b2d`FVw028WYMlS:/2]pI*uIR>75f/Vz&) q3R`?.Xn:$ hw7tJw?8yZ |%1_. 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 Rehabilitation Guidelines x\ms6|:6B]3~H-ST]HJHcG@>`w,@~9}}&w]|!\=|'t{_?|qcy5ca|O8%Y,npm&7& sMA-#IG71ub~ZE\@>l3c2fW?$->+zz\{M;)kO1yTS^ ^uoS7I? endstream endobj 503 0 obj <. 15 -17,19 Therefore, UCL reconstruction has become a common procedure to address UCL insufficiency in adolescent, collegiate, and professional throwers. Thumb UCL Repair With InternalBrace Ligament Augmentation - YouTube Orthop & Spo Med Op Acc J 3(1)- 2019. OSMOAJ.MS.ID.000151. You are still advised to avoid gripping, grasping and twisting with your thumb. endobj On July 25, 1974, Dr Frank Jobe performed the first ulnar collateral ligament (UCL) reconstruction on Los Angeles Dodgers pitcher Tommy John ( Fig. Thumb UCL Repair With Internal Brace Ligament Augmentation % Subsequently, the adductor pollicis aponeurosis and extensor mechanism are identified, incised, and retracted. 502 0 obj <> endobj Tommy John vs UCL Repair Armored Heat 3 0 obj 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 Thumb Collateral Ligament Injuries, most commonly ulnar collateral (UCL), are athletic injuries that lead to a decrease in effective thumb pinch and grasp. 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 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. stream : 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: invite research legit; orange county police department california; hydra stop brake booster This technique involves the reattachment of the ligaments to the bone using FiberWire. Rehabilitation Following UCL Repair with Internal Brace. 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. %%EOF TREATMENT: Treatment consists of either a period of splintage or if completely torn,a repair of the ligament with an operation. Restrictions: No heavy lifting greater than 0 lbs. 557 0 obj <>stream At the ulnar aspect of the thumb MCP joint, a longitudinal midaxial incision is made. ~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 1 0 obj endstream endobj startxref &H+JIKv)ATPJ};CH endobj The UCL may be strained or torn (partially or completely) producing a weakened grasping or pinching ability of the thumb. During this time, active ROM is started as well as light isotonic . A recently developed UCL repair procedure with an internal brace, utilizing collagen tape, is gaining popularity. Diagnosis relies upon thumb MCP radial-ulnar stress exam and MRI studies. stream Repair of the Ulnar Collateral Ligament of the Elbow: Rehabilitation Postoperative protocol. 49 0 obj <> endobj PubMed PMID: 30862273. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> %%EOF y!my6gvF-~g,8\'N&p[t|x0 u0vNzSKjZ*C(hZ}szu9`3_?=/ PDF Elbow Ulnar Collateral Ligament (UCL) Repair Rehabilitation Protocol 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 Whilst both terms are often used interchangeably, the skier's thumb refers to the cause as being acute injury. <>/Metadata 83 0 R/ViewerPreferences 84 0 R>> 4 0 obj K\'~8_c3(rKC-,9/$&nd#{:+H>>*/yGG`b9.`\z. Acute UCL tears: Thumb spica splint/cast for up to 4 weeks, interphalangeal joint free. The Orthopaedic and Fracture . 213 Figure 1: The UCL repair with the internal brace inserted within the ligament. %PDF-1.7 UCL Repair; Young overhead athletes who sustain an injury to their medial ulnar collateral ligament (UCL) complex, isolated to the proximal or distal end of the ligament and without chronic attritional damage, may benefit from a repair rather than a reconstruction procedure.1 Reference 1. 2 0 obj DOI: 10.32474/OSMOAJ.2019.03.000151. <>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> %%EOF !-twF)rm16:M.J r]Sc]Oi~ your repair for 4 more weeks. -Aggressive thumb active motion -The use of the internal brace makes for a very stable construct -AROM and PROM of thumb CMC and IP -No pinching/grabbing/lifting . PDF Rehabilitation Following UCL Repair with Internal Brace - Lupine Publishers Brace: Elbow ROM 30-100 Cryotherapy: Continue ice to elbow joint and graft site . %PDF-1.6 % <> *`]hgTTS:MV{gXS&K|-3m Athletes Can Return to Play in Half the Time with New Thumb Ligament 6=J). cfzn(WH`&8:YUx~Ru1?-K)N(-cY2N[wH.A^Nu1T lTr[wyKt1+oE.Bj^&Q 2)A*a0'AY(|\k2E M * m| ""/+Gq ULNAR COLLATERAL LIGAMENT REPAIR with INTERNAL BRACE Postop protocol for Daniel Myer, M.D. Background: The purpose of this study is to describe our technique of thumb ulnar collateral ligament (UCL) repair with suture tape augmentation and to evaluate the short-term outcomes in our initial series of patients treated with this method of repair.Methods: Patients with minimum one-year follow up after isolated UCL repair with suture tape augmentation were contacted for clinical . Elsevier. @B 8XqhPTU&] ia$A{B;*QX% ]p7L`k?g.G{"z)UU(YY%y\*.ic-PtB *qjbeBA1~ 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. Dressing changed at 7-10 days after surgery Week 2 6f*&aibfSwv{tNcj7Dcg_7ml0`afdMq{Ccbm*"CAp lI"5JK>nt=tuGi0E1O{c2{n BOIu}B)wQ78LyWe-|k#$B/y*jY8 t7X,RpATy+{,q(3#/Plb 'xA+^v(o[l!O U=2EE#/gtcXjQO17D[=tvq;2T(=X"#n:fZ=%S-` ]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 Elbow Ulnar Collateral Ligament (UCL) Repair Rehabilitation Protocol Kelly Holtkamp, M.D. This animation demonstrates repair of the ulnar collateral ligament of the thumb with the InternalBrace ligament augmentation procedure. 148 0 obj <>stream rt$mZE%'l6gIM*9;J1HIo1Z5F`$y-J+"kI.h&pjIhcLS[Ks9Ol|2:}Uu>i4~]t5sY=Bpnjb.-q M=q]9B!EOc6,Oq%4M 5eZ?DwEH 6h3)N1gzSVuQFoaxsARd. This design severely limits functional use of the thumb. c5(Ly%CDer,ZbE+ImgILF cy9 Volume 3 ssue 1 Coprig Kevin ilk et al. At 6 weeks after surgery, the supportive brace should be worn with activities, but you may do light tasks, such as typing without it. Nexus Day Surgery Centre on LinkedIn: Thumb UCL Repair With The triangular fibrocartilage complex (TFCC) is an important stabilizer of the distal radioulnar joint (DRUJ). UCL Repair With Internal Bracing - The Wave of the Future? x]kF_!BBf%I(BTb%]3NrqO%)(V}nu+;jvcyiwuY[_4*j{]e>gUQU~"_e? PDF UCL/RCL Thumb MP Joint Repair Rehabilitation Protocol - Ortho Illinois Brotzman, S. & Novotny, S. (2018). 4 0 obj 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[[oF~70/ 8m6EMc/El%{JaeQlQCwnz5fy3iboob9jV 2019 Apr;49(4):253-261. doi: 10.2519/jospt.2019.8215. -Hand based thumb spica brace (comfort cool) . 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. UCL Surgery- Internal Brace Repair or Reconstruction - Lenny Macrina The rise of ulnar collateral ligament reconstruction and the fall of ulnar collateral ligament repair. Duration: 01:52. hb``d``jd```y No driving. 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. The length of each phase varies depending on each patient and depends on tissue healing and progression. They also showed that internal brace repair performs similarly to the docking reconstruction technique . al., a radial-based thumb MCP orthosis designed to leave the thumb IP and CMC joints free limited thumb abduction which reduced the strain on the thumb UCL when loads were applied. /&E-{BpR`buqyxw{y1E2vzy!`reY,$OcvCnbv_]pyu_//~0]8~t2Vj-/U x[[o:~xpPh.IvEMmi3C]lQ,z X3*{c{XKbMa;{;o>H&PIffS+e@.+>|7mw;L"cH"dMn8)Sy,2*npGWwE&k=|"tbE}%2*R0(jK(s#.$"X$VcY#>J>2pCMW[XHOq{ = wD0NC?IF5tV$ZtR& K"=,`y];]NxIo>r?R'n)locmMuf$[g6\1eu8^s=POm6|GHkOzDuDiIpqT+"'"%;ED/,H$g=Ie9fRH*/ 6Tc`;GJEwvQ*X}:LGKX`n)Bq)su9:qF~b. Finger spring: Place a large rubber band around the outside of your thumb and fingers. These tears often occur as a result of a radially directed force on an extended thumb. <>>> % !V!B;nkGL#_cz5asG) 0<>;Qm4P]3@41oJ5i~o;sJvQv9f r4A-C -Z]>T]Fo hb```) $- `>bPO,VLW0ba6d.fb>4mfBs2hef`t| PDF Rehabilitation Guidelines for UCL Repair with Internal Brace. %PDF-1.7 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. SYMPTOMS: The thumb may be swollen, bruised and painful. 4 0 obj <> <> Return to Play in Athletes After Thumb Ulnar Collateral Ligament Repair UCL REPAIR WITH INTERNAL BRACE . 6,15,19,20,24,29 First described by Frank Jobe in 1986, the procedure has undergone significant evolution . |1WwD >(E>[ X\j&7< 6whY+}v39v/1/wJU-nGQ v JCJX*?=XrtbgS#Nl|wk\6Ac /{h6*!(K6abZ}6M3RUl+pm@k=do3aCyF*wrVN7DixiDaLb^x)G. Hand and Wrist endobj endobj thumb collateral ligament | Medical Billing and Coding Forum - AAPC 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>? 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. Thumb Metacarpophalangeal Ulnar and Radial Collateral Ligament Injuries '_'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 protocolbest mossberg 500 heat shield Fine Art LLC thumb ucl repair with internal brace protocol . ULNAR COLLATERAL LIGAMENT (UCL) REPAIR REHABILITATION PROTOCOL Brace: Hinged elbow brace open to achievable and comfortable ROM as determined by therapist ROM: 0-100 by week 4 Progress active elbow flexion as tolerated Full shoulder and wrist ROM Therapeutic Exercises: Wrist isometrics (pronation, supination) endobj Non-weight bearing to operative extremity. <>/Metadata 558 0 R/ViewerPreferences 559 0 R>> 0 %PDF-1.6 % m"cpQ|fP]3{&N5)M7!s( c A@%'I0*>% J$WNDoN`OM" ,aIENP57SNP zg FQVI@L+ F}t 8Bpt 3x` Q/}2cd}2"[& VL1zeGe:Jz). PDF Institute for Orthopaedic Surgery 1 0 obj endstream endobj startxref The goal is to PDF ULNAR COLLATERAL LIGAMENT REPAIR with INTERNAL BRACE Postop protocol Z\m>~?)I|%X$;-5X&gV+Kms?XRC5%x_ui6q |KdeW7mQUY3s`NB) =gY|6:51c_t]]MixSTB PDF Thumb UCL Repair (Internal Brace) - Orlando Hand Surgery Surgical management of acute combined injuries of the ipsilateral wrist (1) See image 2. 2 0 obj % endobj 128 0 obj <>stream PDF Ulnar Collateral Ligament (Ucl) Repair Rehabilitation Protocol >W ` 8;d3^ H00:GCp#r x At 4 to 6 weeks, removable thumb spica splint, and protected range-of-motion exercises. Phase I - Maximum Protection: 0 to 7 Days: Immobilization in posterior splint at 60-90 of elbow flexion . PDF Thumb UCL Repair- Early Mobilization - UW Health hbbd```b``3@$S=d`6;dq7.`.df`\0LE-`6H rlg4okAdaHMH Resource Type: Surgical Technique Animations. q . &AaBCZKqi =ip;!%RqhH%1[6[8]fwFxw l4)W%5 % Walters BL, Cain EL, Emblom BA, Frantz JT, Dugas JR. 3 0 obj REHABILITATION PROTOCOL: ULNAR COLLATERAL LIGAMENT REPAIR/RECONSTRUCTION RADIAL COLLATERAL LIGAMENT REPAIR/RECONSTRUCTION THUMB MP JOINT WITH INTERNAL BRACE A. J. Mencias, M.D. Initiate Throwing: 14-16 weeks (3.22 Months for Comparison) Bullpens: 24 Weeks (5.52 Months) Live BPs: 30-33 Weeks . (} oA%Yv:JzFQA 0X"5o A%U- MLZ;?3%RO8?DnQN['y]{_5%x@iSt>K2! hb``g``Zs01G83023>"`*`+MKx.00e)zz oIB`F2Af*LoApKX@D l^" <>/Metadata 102 0 R/ViewerPreferences 103 0 R>> thumb ucl repair with internal brace protocol Ulnar collateral ligament injury in the elbow: current trends for At 6 to 12 weeks, begin adductor and interossei strengthening, avoiding valgus stress on thumb MCP. 9f(I#]F)jQ#qbgMkZVcqhLL9{3qjU2s7)#t&"lCn'_|m+L(J:vGagJ}nab<4WGSlc.t)rT)B4"& iaS?DVn##oI&70x~o >I9XbiV`J"mE,R6,qQz"n@d,dSqd{]kE=Jxf0@.,M8^sqAGa[)^-6^`sAI@Q|p4&.grv-P_8 | endobj Journal articles: 'Muscle microtrauma' - Grafiati ,.l(\r @48 dJ^ %$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 <> 0 V8FW The Effect of Ulnar Collateral Ligament Repair With Internal Brace 4 0 obj k,/f&;}P7# Lg W*lwHOPC(LZc>XgI3j:][1/+YX-?p%"6_NaWFv%k]|{6e@Ij 2 0 obj PDF Department of Rehabilitation Services Physical Therapy 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. Ulnar collateral ligament (UCL) injuries have significantly increased over the past few decades, especially in young throwing athletes. 1 0 obj At 10 to 12 weeks, return to . hV]OF+B^ endobj 110 0 obj <> endobj Dr. Allen Thumb UCL Reconstruction Rehabilitation Protocol Phase I: Immediate Post-Op (Weeks 0-2) . endobj Shoulder isometrics (no shoulder internal rotation) Biceps isometrics . Key Timeframes: (Dr Meister/TMI Protocol) Plyometric Phase: 12-14 weeks. hb```-B ce`a}`QJ se fpXF5#m-2q#M=T.Q,A%@ -& B@P xIq;8W2K0e7oS^s&3w&iO'i`4a` 1-3 Candidates for repair are most commonly young er (pre-professional) and present ( E`\Boy 'n"%QBiClMVmfzKRbq"j>Ws$ !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 EXHIBIT(S) - D (Motion #1) EXHIBIT D - Verified Bill of Particulas and << /Length 5 0 R /Filter /FlateDecode >> 7-10 day post-op OT to fabricate a custom FA based thumb spica AROM of the wrist and IP of thumb 4 0 obj 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 . 14 Days Postoperative Do NOT remove the surgical bandage. 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 With the UCL repair, the surgeon will repair your native ligament and re-attach it to it's respective insertion site. stream Open your fingers to stretch the rubber band. Background:Thumb ulnar collateral ligament (UCL) tears are common in competitive athletes. 0 1). Gamekeepers Thumb: Symptoms, Surgery, & Treatment - Hand and Wrist Postoperative Rehabilitation 7-10 days postop The bulky compressive dressing is removed. Thumb Ulnar Collateral Ligament Tear - Tran Plastic Surgery Rehab Protocol - Thumb UCL Repair (Internal Brace Only) Dr. Broering PRECAUTIONS Full time splint use except for ROM. ?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_ 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 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). 4 0 obj Thumb UCL Repair With InternalBrace Ligament Augmentation. 2 0 obj 0 The anti edema management will continue for several weeks. 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 . 1 0 obj &H<0LElM0i""(P f4G0 H2a`70&E00v$`?W r Hrut LF?L . 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. UCL Repair with Internal Bracing versus UCL Reconstruction (Tommy John). 8q`Au8UnN6LW6eS4zdH 7gJRco6aDA+)vg+|Pn.Tz8W>dt+O)1L *XM qD#qHU vr@^zo+Uwe#-`0XLij1 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 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. Reference Number: AN1-00264-en-US | Version: C. Related Pages. Thumb Ulnar Collateral Ligament repair; A Step by Step Guide

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