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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. The native ligament is repaired and then augmented with the internal brace to provide increased strength to allow for a faster recovery.

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.  

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.

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, particularly overhead throwing athletes. It restores a full range of motion in the elbow for the athlete to return 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. 
  • 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 someone to drive you home after surgery

Procedure of UCL Repair with Internal Brace

The surgery involves the following steps:

  • You are positioned to lie on your back (supine position) with the arm placed out on a table
  • You may be given general and regional anesthesia.
  • An incision is made near the medial epicondyle of your elbow towards the UCL ligaments.
  • The ulnar nerve is protected and mobilized.
  • Your surgeon performs debridement of any damaged tissues.
  • The native ligament is examined and assessed for suitability for repair
  • Suture anchors are placed at the point of origin or insertion of the ligament to repair it back to bone
  • A collagen-coated (internal brace) tape is also placed to overly the repaired ligament and secured to the bone
  • Care is taken to avoid damage to any nearby nerves.
  • The incision is closed with sutures and covered with a sterile dressing.

Risks and Complications

Complications are rare but can include:

  • Infection
  • Limited range of motion
  • Nerve damage 
  • Elbow instability

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