thumb ucl repair with internal brace protocol thumb ucl repair with internal brace protocol

Dressing changed at 7-10 days after surgery Week 2 Surgery may also require repairing the avulsion fracture using a pin, screw, or bone anchor. Rehabilitation Following UCL Repair with Internal Brace. Injuries to the ulnar collateral ligament of the thumb metacarpophalangeal joint (gamekeeper's thumb). % Rehabilitation Guidelines 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) -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 . 3 0 obj 1 Major components of the TFCC are the articular disc (AD), meniscus homolog, radioulnar ligaments, and extensor carpi . This includes, but not limited to, self-retrograde massage, cold therapy, and extremity elevation. stream Rehabilitation following UCL repair with internal brace is accelerated by comparison to Tommy John Surgery. ULNAR COLLATERAL LIGAMENT REPAIR with INTERNAL BRACE Postop protocol for Daniel Myer, M.D. At 4 to 6 weeks, removable thumb spica splint, and protected range-of-motion exercises. General time frames are given for reference to the average, but individual patients will progress at different rates depending on their age, &H+JIKv)ATPJ};CH |C&K 0g-Pf4/.B{s. See Tua at the University of Alabama, for examaple. 4 0 obj 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. x[[o~70/5+/@`dk4],`hHp}9C9\YBKP.e?}|S-~K3KbEpSXy~ldpL"$.XHf>_~}d?Te5Zs$Rpdt <>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> %PDF-1.5 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. 1-3 Candidates for repair are most commonly young er (pre-professional) and present Jsx cx=[wOGvu UV]QEMtejL11eO2\5~B*q>vvcu9]dtUbqjNU{ <>/Metadata 83 0 R/ViewerPreferences 84 0 R>> 2 0 obj Read court documents, court records online and search Trellis.law comprehensive legal database for any state court documents. Recently, Dugas et al. 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 Open your fingers to stretch the rubber band. <> PDF | Background: Combined injuries of ipsilateral wrist and elbow joints are rare in clinical practice, characterized by multiple joint dislocations. hV]OF+B^ @B 8XqhPTU&] ia$A{B;*QX% ]p7L`k?g.G{"z)UU(YY%y\*.ic-PtB *qjbeBA1~ &AaBCZKqi =ip;!%RqhH%1[6[8]fwFxw l4)W%5 Finger spring: Place a large rubber band around the outside of your thumb and fingers. Initiate Throwing: 14-16 weeks (3.22 Months for Comparison) Bullpens: 24 Weeks (5.52 Months) Live BPs: 30-33 Weeks . stream 15 -17,19 Therefore, UCL reconstruction has become a common procedure to address UCL insufficiency in adolescent, collegiate, and professional throwers. endobj Thumb UCL Repair With InternalBrace Ligament Augmentation What's New in Orthopedics 207K subscribers Subscribe 24 Save 3.8K views 1 year ago .more .more Notice Age-restricted video. x[[o:~xpPh.IvEMmi3C]lQ,z X3*{c{XKbMa;{;o>H&PIffS+e@.+>|7mw;L"cH"dMn8)Sy,2*npGWwE&k=|"tbE}%2*R0(jK(s#.$"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. Its many uses has helped numerous athletes return back from their injuries quicker than ever. 2 0 obj PubMed PMID: 30862273. % endstream endobj startxref Orthop & Spo Med Op Acc J 3(1)- 2019. REHABILITATION PROTOCOL: ULNAR COLLATERAL LIGAMENT REPAIR/RECONSTRUCTION RADIAL COLLATERAL LIGAMENT REPAIR/RECONSTRUCTION THUMB MP JOINT WITH INTERNAL BRACE A. J. Mencias, M.D. 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. 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 7-10 day post-op OT to fabricate a custom FA based thumb spica AROM of the wrist and IP of thumb Brotzman, S. & Novotny, S. (2018). 1 0 obj Subsequently, the adductor pollicis aponeurosis and extensor mechanism are identified, incised, and retracted. endobj Traditional custom-fitted thumb spica orthosis In a recent cadaver study by Gil et. SYMPTOMS: The thumb may be swollen, bruised and painful. 02M_+ ! Edema control is initiated with a light compression dressing. It's pretty neat to see how it has taken on a whole world of uses, including in the knee and ankle. endobj q DU?f7 # *S During this time, active ROM is started as well as light isotonic . Shoulder isometrics (no shoulder internal rotation) Biceps isometrics . At 6 weeks after surgery, the supportive brace should be worn with activities, but you may do light tasks, such as typing without it. << /Length 5 0 R /Filter /FlateDecode >> 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. %PDF-1.6 % cfzn(WH`&8:YUx~Ru1?-K)N(-cY2N[wH.A^Nu1T lTr[wyKt1+oE.Bj^&Q 2)A*a0'AY(|\k2E M * m| ""/+Gq Postoperative Rehabilitation 7-10 days postop The bulky compressive dressing is removed. 92 0 obj <>stream fPD. 3BRKpw.4/Y. r e c . hb```) $- `>bPO,VLW0ba6d.fb>4mfBs2hef`t| 0 endobj Key Timeframes: (Dr Meister/TMI Protocol) Plyometric Phase: 12-14 weeks. % (1) See image 2. al., a radial-based thumb MCP orthosis designed to leave the thumb IP and CMC joints free limited thumb abduction which reduced the strain on the thumb UCL when loads were applied. At the ulnar aspect of the thumb MCP joint, a longitudinal midaxial incision is made. endobj This internal brace surgery was developed by surgical company Arthrex. hbbd```b``"'Iwh"HVqD``\y "g= ] l+ =&KU20R4@ US your repair for 4 more weeks. Abstract and Figures Acute rupture of the ulnar collateral ligament (UCL) of the thumb - also known as 'skier's thumb' - is a common injury which may cause long-term complications if. When the tear results in pain and instability, surgical repair offers a predictably successful outcome. The UCL may be strained or torn (partially or completely) producing a weakened grasping or pinching ability of the thumb. Citation: Kevin E Wilk, Christopher A A, Rebekah J A. ULNAR COLLATERAL LIGAMENT OF THE ELBOW RECONSTRUCTION USING AUTOGENOUS GRAFT PROTOCOL 3 Progress shoulder isometrics to isotonics, emphasize rotator cuff strengthening (Avoid resisted external rotation until 6th week to minimize forces on repaired UCL) Week 6 Brace - hinged elbow brace set 0-130 degrees. The UCL is the main ligament, located on the inner aspect at the base of the thumb, which stabilizes the metacarpophalangeal (MCP) joint. The length of each phase varies depending on each patient and depends on tissue healing and progression. POST-OPERATIVE WEEK 2. !bq\n#z0y/16C0DLP"2wn|e&35`MX2 @@^ !+~(l)2B3% !!PsEUr,!NAqYkT0(*${YNB_sYGDa|)jN!vE ` Gc^N.&/v;5$*'BDh8P}!k!2YK-|)T\{|eF_xXC'o]8 yLt)n reported 92% success some returning overhead athletes to the same a high level of competition is an average of 6.7 months with UCL repair and internal brace . 128 0 obj <>stream The triangular fibrocartilage complex (TFCC) is an important stabilizer of the distal radioulnar joint (DRUJ). The athletes that were treated with UCL repair and internal . Dr. Allen Thumb UCL Reconstruction Rehabilitation Protocol Phase I: Immediate Post-Op (Weeks 0-2) . At 10 to 12 weeks, return to . <> ?3U,a_~`XRUWcQT2r?B73pgry.v3}w/2\Fz?6-SHK PXUU9:!$\@j)b;}r% /5 V5uz @ TY}]7KX75F1"3#TZLY|A/+{gc_?olhfGmHwiiB%"=CH$ai-`75 gdkZ_ Ulnar Collateral. 6=J). Thumb Collateral Ligament Injuries, most commonly ulnar collateral (UCL), are athletic injuries that lead to a decrease in effective thumb pinch and grasp. Elbow Ulnar Collateral Ligament (UCL) Repair Rehabilitation Protocol Kelly Holtkamp, M.D. !-twF)rm16:M.J r]Sc]Oi~ Thumb UCL Repair and Reconstruction With Internal Brace Ligament Augmentation Repair Ulnar collateral ligament (UCL) tears of the thumb are common injuries. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 3 0 obj endobj What causes GameKeeper's Thumb? <> EXHIBIT(S) - D (Motion #1) EXHIBIT D - Verified Bill of Particulas and Responses to Various Demands Redacted per 22 NYCRR - EXHIBIT D - Verified Bill of Particulas and Responses to Various Demands Redacted February 09, 2023. <> hWmo6+KI A ;WcIZ2LVaj%%u70y{l800`$p(AI6GBNP8S,CCrJcr\) %PDF-1.3 Resource Type: Surgical Technique Animations. ["BIA+ryv_cNaICaNJ!E.|dXTp3g@9< HTxS % 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 . 4 0 obj 2 0 obj Ligament / Volar Plate CPT Codes. ,.l(\r @48 dJ^ %$HU 44HK[Y.D;2d8A1 d9\Imog|G|L8p,b}- BT"/q[[%p4)dl0( TOO#]x~0zKGeyk7-Zb!Z]#_@As r1'B04Lq0tS>Yf0lUQ0z.?9M7eCe[4^orMi|yF`8j_z\p=-g:I}^\RVDw*w hYmO8+NR)nEr'@]fuv4RUB;OfP&,!z3$Q"9#*m cLC. `eDp4)J00"2N$b\3HZhSCR stream k,/f&;}P7# Lg W*lwHOPC(LZc>XgI3j:][1/+YX-?p%"6_NaWFv%k]|{6e@Ij This technique involves the reattachment of the ligaments to the bone using FiberWire. In a recent laboratory study conducted by the Arthrex Research Department using cadaver specimens, the thumb UCL with internal brace was four times stronger than the standard repair with suture alone. %%EOF UCL REPAIR WITH INTERNAL BRACE . y!my6gvF-~g,8\'N&p[t|x0 u0vNzSKjZ*C(hZ}szu9`3_?=/ The rehabilitation protocol after a Ulnar Collateral Ligament Repair with Internal Brace surgery typically involves several phases. The ulnar collateral ligament (UCL) does not play a large role in elbow stability for most activities of daily living, but it does undergo tremendous stresses with overhead throwing and is susceptible to injury in overhead athletes. Brace: Elbow ROM 30-100 Cryotherapy: Continue ice to elbow joint and graft site . 110 0 obj <> endobj << /Length 5 0 R /Filter /FlateDecode >> If %%EOF *XM qD#qHU vr@^zo+Uwe#-`0XLij1 1. K\'~8_c3(rKC-,9/$&nd#{:+H>>*/yGG`b9.`\z. Educate the patient on anti edema management. stream Thumb UCL Repair (Internal Brace) 0-2 weeks: The postoperative dressing is removed. 0 At 6 to 12 weeks, begin adductor and interossei strengthening, avoiding valgus stress on thumb MCP. 1 i^D=)ngloqvb_3.&3e/.[A GF;'YDL65_lZ4l$!`,yv I(=wY */xZFXDI6%t0^&2L7@~DSN1& 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 <> Thumb UCL may be repaired with Internal Brace Ligament Augmentation. Volume 3 ssue 1 Coprig Kevin ilk et al. Reference Number: AN1-00264-en-US | Version: C. Related Pages. hb```-B ce`a}`QJ se fpXF5#m-2q#M=T.Q,A%@ -& B@P xIq;8W2K0e7oS^s&3w&iO'i`4a` UCL Repair with Internal Bracing versus UCL Reconstruction (Tommy John). 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. Thumb UCL Repair- Early Mobilization This protocol is intended to provide the clinician with a . 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 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 You are still advised to avoid gripping, grasping and twisting with your thumb. %PDF-1.6 % 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). Finger and hand range of motion: maintain AROM and PROM 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 . Practice this exercise for about 5 minutes. endstream endobj 503 0 obj <. The UCL repair with Internal Brace was developed as a faster alternative to a full UCL reconstruction. The InternalBrace 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 Revision Date: 10/29/2021. 1 0 obj <>/Metadata 102 0 R/ViewerPreferences 103 0 R>> endobj 148 0 obj <>stream 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 |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. 14 Days Postoperative Do NOT remove the surgical bandage. endstream endobj startxref <> Diagnosis relies upon thumb MCP radial-ulnar stress exam and MRI studies. The goal is to OSMOAJ.MS.ID.000151. Exercises: Continue all exercises listed above Elbow ROM in brace (-30 to 100) Initiate isometric elbow extension Initiate wrist isometrics %PDF-1.7 &H<0LElM0i""(P f4G0 H2a`70&E00v$`?W r FWfvgYpmphZsrDo\!WG-W.4BAj]Z^4~v:34a'9cl'LlL/Ka:XsWpv>{|MGK>\#(hO 3 0 obj hb``d``jd```y ( E`\Boy 'n"%QBiClMVmfzKRbq"j>Ws$ <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Elevate, ice and modalities to reduce pain and inflammation . | Find, read and cite all the research you . invite research legit; orange county police department california; hydra stop brake booster Return to Play in Athletes After Thumb Ulnar Collateral Ligament Repair With Suture Tape Augmentation - Daniel B. Gibbs, Steven S. Shin, 2020 >W ` 8;d3^ 557 0 obj <>stream 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: ]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 Mrtl7"l\Q`?v`d: 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. hbbd```b`` "gA$d^ %PDF-1.7 6,15,19,20,24,29 First described by Frank Jobe in 1986, the procedure has undergone significant evolution . 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. 1). 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. sHSlC:">)n2oAGV?vtE6f?r83bSXk8[~@t(zQXA>)V|@)} 1&%_qU}VuA (nKS"(;VB| >`UVtXb#xEpF,Z%ZX["'XP Clinical Orthopeadic Rehabilitation: A Team Approach E-Book, 4th Edition. Phone: 574.247.9441 Fax: 574.247.9442 www.sbortho.com REHABILITATION PROTOCOL: THUMB UCL/RCL REPAIR SAM FULLER, M.D. Epub 2019 Mar 12. 213 Figure 1: The UCL repair with the internal brace inserted within the ligament. Restrictions: No heavy lifting greater than 0 lbs. endobj endstream endobj startxref endobj endstream endobj startxref <> hbbd```b``3@$S=d`6;dq7.`.df`\0LE-`6H rlg4okAdaHMH 3 0 obj %%EOF 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. 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). Hrut LF?L . 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. 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. 1 0 obj Phase I - Maximum Protection: 0 to 7 Days: Immobilization in posterior splint at 60-90 of elbow flexion . % 2019 Apr;49(4):253-261. doi: 10.2519/jospt.2019.8215. %PDF-1.6 % 49 0 obj <> endobj . ~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 @` I8 endobj stream 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>? endobj endobj % A recently developed UCL repair procedure with an internal brace, utilizing collagen tape, is gaining popularity. 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 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 . 4 0 obj Ulnar collateral ligament (UCL) injuries have significantly increased over the past few decades, especially in young throwing athletes. 4 0 obj TREATMENT: Treatment consists of either a period of splintage or if completely torn,a repair of the ligament with an operation. <> H00:GCp#r x Non-weight bearing to operative extremity. &Dam[L1-J" iiBUq[{0R 3xVoEouUja,Jd> k '! Background:Thumb ulnar collateral ligament (UCL) tears are common in competitive athletes. endobj 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 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. 2 0 obj 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 The rise of ulnar collateral ligament reconstruction and the fall of ulnar collateral ligament repair. 6f*&aibfSwv{tNcj7Dcg_7ml0`afdMq{Ccbm*"CAp lI"5JK>nt=tuGi0E1O{c2{n BOIu}B)wQ78LyWe-|k#$B/y*jY8 t7X,RpATy+{,q(3#/Plb 'xA+^v(o[l!O U=2EE#/gtcXjQO17D[=tvq;2T(=X"#n:fZ=%S-` To date, no literat. 3 0 obj <> 1 0 obj aY_dM\\Kq[SZ 6| F8$b2d`FVw028WYMlS:/2]pI*uIR>75f/Vz&) q3R`?.Xn:$ hw7tJw?8yZ |%1_. endobj Rehab Protocol - Thumb UCL Repair (Internal Brace Only) Dr. Broering PRECAUTIONS Full time splint use except for ROM. The Orthopaedic and Fracture . <>>> !V!B;nkGL#_cz5asG) 0<>;Qm4P]3@41oJ5i~o;sJvQv9f r4A-C -Z]>T]Fo '_'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. x\ms6|:6B]3~H-ST]HJHcG@>`w,@~9}}&w]|!\=|'t{_?|qcy5ca|O8%Y,npm&7& sMA-#IG71ub~ZE\@>l3c2fW?$->+zz\{M;)kO1yTS^ ^uoS7I? 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. endobj 502 0 obj <> endobj <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> %PDF-1.7 Walters BL, Cain EL, Emblom BA, Frantz JT, Dugas JR. 8q`Au8UnN6LW6eS4zdH 7gJRco6aDA+)vg+|Pn.Tz8W>dt+O)1L DOI: 10.32474/OSMOAJ.2019.03.000151. 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. c5(Ly%CDer,ZbE+ImgILF cy9 <>/Metadata 558 0 R/ViewerPreferences 559 0 R>> On July 25, 1974, Dr Frank Jobe performed the first ulnar collateral ligament (UCL) reconstruction on Los Angeles Dodgers pitcher Tommy John ( Fig. This design severely limits functional use of the thumb. 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 | 0 . V8FW 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 0 <>/Metadata 554 0 R/ViewerPreferences 555 0 R>> x[[oF~70/ 8m6EMc/El%{JaeQlQCwnz5fy3iboob9jV Postoperative protocol. These tears often occur as a result of a radially directed force on an extended thumb. The success of that surgery resulted in it being called the Tommy John procedure. Acute UCL tears: Thumb spica splint/cast for up to 4 weeks, interphalangeal joint free. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 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. -Hand based thumb spica brace (comfort cool) . J Orthop Sports Phys Ther. %%EOF %PDF-1.3 They also showed that internal brace repair performs similarly to the docking reconstruction technique . Duration: 01:52. hbbd```b``Z";d,d"? Hand and Wrist 4 0 obj Instruct the patient to begin active range of motion exercises of the thumb without stressing the UCL/RCL repair.