thumb ucl repair with internal brace protocol

Rehabilitation following UCL repair with internal brace is accelerated by comparison to Tommy John Surgery. endstream endobj startxref Postoperative protocol. <> % Volume 3 ssue 1 Coprig Kevin ilk et al. %PDF-1.7 << /Length 5 0 R /Filter /FlateDecode >> Rehabilitation Guidelines Jsx cx=[wOGvu UV]QEMtejL11eO2\5~B*q>vvcu9]dtUbqjNU{ Educate the patient on anti edema management. OSMOAJ.MS.ID.000151. Diagnosis s/p RIGHT/LEFT UCL Repair with Internal Brace Date of Surgery_____ Frequency: ____ times/week Duration: _____ Weeks Week 1: Elbow is immobilized in Hinged Elbow Brace at 75 degrees flexion (7 - 10 days), wrist free, in sling. ULNAR COLLATERAL LIGAMENT OF THE ELBOW RECONSTRUCTION USING AUTOGENOUS GRAFT PROTOCOL 3 Progress shoulder isometrics to isotonics, emphasize rotator cuff strengthening (Avoid resisted external rotation until 6th week to minimize forces on repaired UCL) Week 6 Brace - hinged elbow brace set 0-130 degrees. Practice this exercise for about 5 minutes. %PDF-1.6 % Dr. Allen Thumb UCL Reconstruction Rehabilitation Protocol Phase I: Immediate Post-Op (Weeks 0-2) . 14 Days Postoperative Do NOT remove the surgical bandage. Citation: Kevin E Wilk, Christopher A A, Rebekah J A. 15 -17,19 Therefore, UCL reconstruction has become a common procedure to address UCL insufficiency in adolescent, collegiate, and professional throwers. 3 0 obj . Phase I - Maximum Protection: 0 to 7 Days: Immobilization in posterior splint at 60-90 of elbow flexion . 148 0 obj <>stream 4 0 obj !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 -Hand based thumb spica brace (comfort cool) . With the UCL repair, the surgeon will repair your native ligament and re-attach it to it's respective insertion site. |C&K 0g-Pf4/.B{s. %PDF-1.7 <> What causes GameKeeper's Thumb? Hrut LF?L . | Find, read and cite all the research you . Initiate Throwing: 14-16 weeks (3.22 Months for Comparison) Bullpens: 24 Weeks (5.52 Months) Live BPs: 30-33 Weeks . @B 8XqhPTU&] ia$A{B;*QX% ]p7L`k?g.G{"z)UU(YY%y\*.ic-PtB *qjbeBA1~ x[[o~70/5+/@`dk4],`hHp}9C9\YBKP.e?}|S-~K3KbEpSXy~ldpL"$.XHf>_~}d?Te5Zs$Rpdt The newer repair procedure utilizes internalbrace, which comprises high-strength fibertape suture, to reenforce and protect the ligament while it is healing, and provide additional protection during throwing activities. During this time, active ROM is started as well as light isotonic . endstream endobj startxref Thumb UCL Repair and Reconstruction With Internal Brace Ligament Augmentation Repair Ulnar collateral ligament (UCL) tears of the thumb are common injuries. ( E`\Boy 'n"%QBiClMVmfzKRbq"j>Ws$ <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Right after the surgery, the elbow is secured in a brace at a 60- to 90-degree angle. 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. Reference Number: AN1-00264-en-US | Version: C. Related Pages. 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"$(MjTy 4 0 obj endobj TREATMENT: Treatment consists of either a period of splintage or if completely torn,a repair of the ligament with an operation. The success of that surgery resulted in it being called the Tommy John procedure. Background:Thumb ulnar collateral ligament (UCL) tears are common in competitive athletes. Postoperative Rehabilitation 7-10 days postop The bulky compressive dressing is removed. UCL REPAIR WITH INTERNAL BRACE . <> stream |1WwD >(E>[ X\j&7< 6whY+}v39v/1/wJU-nGQ v JCJX*?=XrtbgS#Nl|wk\6Ac /{h6*!(K6abZ}6M3RUl+pm@k=do3aCyF*wrVN7DixiDaLb^x)G. stream stream stream Joint destruction compresses nerve roots, resulting in pain, paresthesia, sensory loss, dysautonomia, and spasticity. 104 0 obj <>/Filter/FlateDecode/ID[<33B8DE36AB984B418169C7A4E24F203B><19F8EE0B324BFE44BA1CA95B759557F5>]/Index[79 50]/Info 78 0 R/Length 117/Prev 108309/Root 80 0 R/Size 129/Type/XRef/W[1 3 1]>>stream It was grossly incompetent and irreparable. hb``g``Zs01G83023>"`*`+MKx.00e)zz oIB`F2Af*LoApKX@D l^" <>/Metadata 102 0 R/ViewerPreferences 103 0 R>> UCL Repair Ulnar Collateral Ligament Repair Protocol Ulnar Collateral Ligament Repair Protocol Phase I: Immediate Post-Surgical Phase (Days 1 - 21) Goals: Protect healing tissue, decrease pain and inflammation, increase scar mobility, prevent muscular atrophy Exercises: &H+JIKv)ATPJ};CH <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 6=J). % K\'~8_c3(rKC-,9/$&nd#{:+H>>*/yGG`b9.`\z. J Orthop Sports Phys Ther. Recently, Dugas et al. 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. 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]. <> Read court documents, court records online and search Trellis.law comprehensive legal database for any state court documents. As the internal brace technique continues to mature, its application has been gradually expanded to include repair of the anterior talofibular ligament and deltoid ligament in the ankle, anterior and posterior cruciate ligaments, medial and lateral collateral ligaments and medial patellar ligaments in the knee, and ulnar collateral ligaments in . 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 Injuries to the ulnar collateral ligament of the thumb metacarpophalangeal joint (gamekeeper's thumb). PDF | Background: Combined injuries of ipsilateral wrist and elbow joints are rare in clinical practice, characterized by multiple joint dislocations. endobj At 4 to 6 weeks, removable thumb spica splint, and protected range-of-motion exercises. Duration: 01:52. Triangular fibrocartilage complex injury is one of the most common causes of ulnar wrist pain and can impair daily activities, such as door opening and handshaking. 128 0 obj <>stream Elsevier. The Orthopaedic and Fracture . The length of each phase varies depending on each patient and depends on tissue healing and progression. Diagnosis relies upon thumb MCP radial-ulnar stress exam and MRI studies. 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-` The InternalBrace 1 0 obj 0 The UCL may be strained or torn (partially or completely) producing a weakened grasping or pinching ability of the thumb. %PDF-1.6 % 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>? @` I8 endobj There was gross instability of the ulnar collateral . : 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: fPD. 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. On July 25, 1974, Dr Frank Jobe performed the first ulnar collateral ligament (UCL) reconstruction on Los Angeles Dodgers pitcher Tommy John ( Fig. If hb``d``jd```y Open your fingers to stretch the rubber band. by | Jun 3, 2022 | james carone florida energy | when a man criticizes another woman | Jun 3, 2022 | james carone florida energy | when a man criticizes another woman 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 . The brace may be removed for showering and gentle active motion exercises directed by the therapist. stream <> POST-OPERATIVE WEEK 2. The rehabilitation protocol after a Ulnar Collateral Ligament Repair with Internal Brace surgery typically involves several phases. The triangular fibrocartilage complex (TFCC) is an important stabilizer of the distal radioulnar joint (DRUJ). 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. Exercises: Continue all exercises listed above Elbow ROM in brace (-30 to 100) Initiate isometric elbow extension Initiate wrist isometrics When the tear results in pain and instability, surgical repair offers a predictably successful outcome. '_'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. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> The goal is to endobj % 0 endobj hb```-B ce`a}`QJ se fpXF5#m-2q#M=T.Q,A%@ -& B@P xIq;8W2K0e7oS^s&3w&iO'i`4a` 4 0 obj The UCL is the main ligament, located on the inner aspect at the base of the thumb, which stabilizes the metacarpophalangeal (MCP) joint. 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) A bP .a+ZY^tL3ab`y7*n&++c 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 1. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> <>/Metadata 554 0 R/ViewerPreferences 555 0 R>> You are still advised to avoid gripping, grasping and twisting with your thumb. endobj This includes, but not limited to, self-retrograde massage, cold therapy, and extremity elevation. Traditional custom-fitted thumb spica orthosis In a recent cadaver study by Gil et. V8FW REHABILITATION PROTOCOL: ULNAR COLLATERAL LIGAMENT REPAIR/RECONSTRUCTION RADIAL COLLATERAL LIGAMENT REPAIR/RECONSTRUCTION THUMB MP JOINT WITH INTERNAL BRACE A. J. Mencias, M.D. Thumb Ulnar Collateral Ligament Repair Post-Operative Protocol Days 0- until first Post-Op Apt. xZS8~AO[H[ULj!W0"Esvo 0h2ULlYRZ?.-ax0Iz_]0lnY>__-\x2`\DL^dRrzIE:d2bdcz{Izw^,&={y@{w=:'=aa=T()VCA6kGQlS9?LX|^+#{zX/.zLNT^Z^jg]X6g8If55/_BYjWpE\,#w+"6A hV]OF+B^ 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$g=Ie9fRH*/ 6Tc`;GJEwvQ*X}:LGKX`n)Bq)su9:qF~b. cfzn(WH`&8:YUx~Ru1?-K)N(-cY2N[wH.A^Nu1T lTr[wyKt1+oE.Bj^&Q 2)A*a0'AY(|\k2E M * m| ""/+Gq %PDF-1.5 h!DWl{$A4L61)H}hJftyrI%kSQLc]5sbGP U_8v}9|(O(( qsMfGiICYL|*'VL+b% Epub 2019 Mar 12. Ulnar collateral ligament (UCL) injuries have significantly increased over the past few decades, especially in young throwing athletes. 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 1 i^D=)ngloqvb_3.&3e/.[A GF;'YDL65_lZ4l$!`,yv I(=wY */xZFXDI6%t0^&2L7@~DSN1& (1) See image 2. <> % k,/f&;}P7# Lg W*lwHOPC(LZc>XgI3j:][1/+YX-?p%"6_NaWFv%k]|{6e@Ij m"cpQ|fP]3{&N5)M7!s( c A@%'I0*>% J$WNDoN`OM" ,aIENP57SNP zg FQVI@L+ F}t 8Bpt 3x` Q/}2cd}2"[& VL1zeGe:Jz). hYmO8+NR)nEr'@]fuv4RUB;OfP&,!z3$Q"9#*m cLC. `eDp4)J00"2N$b\3HZhSCR Ligament / Volar Plate CPT Codes. 4 0 obj (} oA%Yv:JzFQA 0X"5o A%U- MLZ;?3%RO8?DnQN['y]{_5%x@iSt>K2! This internal brace surgery was developed by surgical company Arthrex. 02M_+ ! Hand and Wrist 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. sHSlC:">)n2oAGV?vtE6f?r83bSXk8[~@t(zQXA>)V|@)} 1&%_qU}VuA (nKS"(;VB| >`UVtXb#xEpF,Z%ZX["'XP the thumb. At the ulnar aspect of the thumb MCP joint, a longitudinal midaxial incision is made. Elbow Ulnar Collateral Ligament (UCL) Repair Rehabilitation Protocol Kelly Holtkamp, M.D. Thumb UCL may be repaired with Internal Brace Ligament Augmentation. 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 . Surgery may also require repairing the avulsion fracture using a pin, screw, or bone anchor. Its many uses has helped numerous athletes return back from their injuries quicker than ever. 502 0 obj <> endobj 1 0 obj 92 0 obj <>stream The rise of ulnar collateral ligament reconstruction and the fall of ulnar collateral ligament repair. 3 0 obj % This animation demonstrates repair of the ulnar collateral ligament of the thumb with the InternalBrace ligament augmentation procedure. The UCL repair with Internal Brace was developed as a faster alternative to a full UCL reconstruction. ]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 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. %PDF-1.7 thumb ucl repair with internal brace protocol. Walters BL, Cain EL, Emblom BA, Frantz JT, Dugas JR. 0 No driving. 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. % It's pretty neat to see how it has taken on a whole world of uses, including in the knee and ankle. 49 0 obj <> endobj SYMPTOMS: The thumb may be swollen, bruised and painful. <> Mrtl7"l\Q`?v`d: x]kF_!BBf%I(BTb%]3NrqO%)(V}nu+;jvcyiwuY[_4*j{]e>gUQU~"_e? Thumb UCL Repair (Internal Brace) 0-2 weeks: The postoperative dressing is removed. Shoulder isometrics (no shoulder internal rotation) Biceps isometrics . endobj c5(Ly%CDer,ZbE+ImgILF cy9 %%EOF Finger spring: Place a large rubber band around the outside of your thumb and fingers. 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. hbbd```b``Z";d,d"? <> 2 0 obj 1 0 obj hbbd```b``"'Iwh"HVqD``\y "g= ] l+ =&KU20R4@ US Ulnar Collateral. ULNAR COLLATERAL LIGAMENT REPAIR with INTERNAL BRACE Postop protocol for Daniel Myer, M.D. This technique involves the reattachment of the ligaments to the bone using FiberWire. r e c . x\ms6|:6B]3~H-ST]HJHcG@>`w,@~9}}&w]|!\=|'t{_?|qcy5ca|O8%Y,npm&7& sMA-#IG71ub~ZE\@>l3c2fW?$->+zz\{M;)kO1yTS^ ^uoS7I? 1). 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 . 1 Major components of the TFCC are the articular disc (AD), meniscus homolog, radioulnar ligaments, and extensor carpi . The athletes that were treated with UCL repair and internal . 8q`Au8UnN6LW6eS4zdH 7gJRco6aDA+)vg+|Pn.Tz8W>dt+O)1L 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. /&E-{BpR`buqyxw{y1E2vzy!`reY,$OcvCnbv_]pyu_//~0]8~t2Vj-/U Key Timeframes: (Dr Meister/TMI Protocol) Plyometric Phase: 12-14 weeks. They also showed that internal brace repair performs similarly to the docking reconstruction technique . At 6 to 12 weeks, begin adductor and interossei strengthening, avoiding valgus stress on thumb MCP. Dressing changed at 7-10 days after surgery Week 2 !-twF)rm16:M.J r]Sc]Oi~ 1 0 obj your repair for 4 more weeks. !V!B;nkGL#_cz5asG) 0<>;Qm4P]3@41oJ5i~o;sJvQv9f r4A-C -Z]>T]Fo 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 3BRKpw.4/Y. 60 0 obj <>/Filter/FlateDecode/ID[<0AF1E1B641B34B46855587C2A48FF27B><237A0C35EE1B4C46B05DEA8683FB9A51>]/Index[49 44]/Info 48 0 R/Length 76/Prev 328473/Root 50 0 R/Size 93/Type/XRef/W[1 3 1]>>stream General time frames are given for reference to the average, but individual patients will progress at different rates depending on their age, Z\m>~?)I|%X$;-5X&gV+Kms?XRC5%x_ui6q |KdeW7mQUY3s`NB) =gY|6:51c_t]]MixSTB 3 0 obj To date, no literat. 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 . Please fax initial evaluation and progress notes to 8153817498. Thumb UCL Repair- Early Mobilization This protocol is intended to provide the clinician with a . ~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 0 Rehab Protocol - Thumb UCL Repair (Internal Brace Only) Dr. Broering PRECAUTIONS Full time splint use except for ROM. 2019 Apr;49(4):253-261. doi: 10.2519/jospt.2019.8215. *XM qD#qHU vr@^zo+Uwe#-`0XLij1 The internalbrace is the underpinning of the repair procedure. endobj H00:GCp#r x In a reconstruction the old, damaged ligament is removed, new portal holes are drilled and (in an autograft situation) a tendon from somewhere else in your body (palmaris longus, hamstring, etc) is docked as the new UCL. endstream endobj startxref 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. Finger and hand range of motion: maintain AROM and PROM Resource Type: Surgical Technique Animations. Thumb UCL Repair With InternalBrace Ligament Augmentation. <> 79 0 obj <> endobj 4 0 obj <>/Metadata 558 0 R/ViewerPreferences 559 0 R>> y!my6gvF-~g,8\'N&p[t|x0 u0vNzSKjZ*C(hZ}szu9`3_?=/ 2 0 obj 2 0 obj PubMed PMID: 30862273. 110 0 obj <> endobj Non-weight bearing to operative extremity. x[[oF~70/ 8m6EMc/El%{JaeQlQCwnz5fy3iboob9jV Elevate, ice and modalities to reduce pain and inflammation . At 6 weeks after surgery, the supportive brace should be worn with activities, but you may do light tasks, such as typing without it. &H<0LElM0i""(P f4G0 H2a`70&E00v$`?W r 6,15,19,20,24,29 First described by Frank Jobe in 1986, the procedure has undergone significant evolution . DU?f7 # *S &AaBCZKqi =ip;!%RqhH%1[6[8]fwFxw l4)W%5 % <>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Phone: 574.247.9441 Fax: 574.247.9442 www.sbortho.com REHABILITATION PROTOCOL: THUMB UCL/RCL REPAIR SAM FULLER, M.D. %%EOF ?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_ Acute UCL tears: Thumb spica splint/cast for up to 4 weeks, interphalangeal joint free. 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. We describe the surgical technique of suture tape augmentation for thumb UCL repair. << /Length 5 0 R /Filter /FlateDecode >> endobj stream 2 0 obj ,.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 A recently developed UCL repair procedure with an internal brace, utilizing collagen tape, is gaining popularity. The anti edema management will continue for several weeks. hWmo6+KI A ;WcIZ2LVaj%%u70y{l800`$p(AI6GBNP8S,CCrJcr\) At 10 to 12 weeks, return to . FWfvgYpmphZsrDo\!WG-W.4BAj]Z^4~v:34a'9cl'LlL/Ka:XsWpv>{|MGK>\#(hO 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. -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-1.3 Edema control is initiated with a light compression dressing. endobj %PDF-1.3 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 Return to Play in Athletes After Thumb Ulnar Collateral Ligament Repair With Suture Tape Augmentation - Daniel B. Gibbs, Steven S. Shin, 2020 endobj 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 . %PDF-1.7 aY_dM\\Kq[SZ 6| F8$b2d`FVw028WYMlS:/2]pI*uIR>75f/Vz&) q3R`?.Xn:$ hw7tJw?8yZ |%1_.

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