endobj ~Y$'h9N`haq8"% {s D)gZ2J =ky~ pP],DQgUh6*DM6`vlK ,R /"0q^p3S;LrV?-VS(6E?VAQJ@p EQQKiqLf[~vA]"`qW `!a`05I**ThsrAD8WH6SXb^h:R.?Q(oeR~R^N Tommy John Surgery | UCL Injury Overview | Dr. Christopher Ahmad At 6 weeks after surgery, the supportive brace should be worn with activities, but you may do light tasks, such as typing without it. %PDF-1.7 Thumb Metacarpophalangeal Ulnar and Radial Collateral Ligament Injuries Skier's Thumb (Ulnar Collateral Ligament Sprain) Exercises EXHIBIT(S) - D (Motion #1) EXHIBIT D - Verified Bill of Particulas and It was grossly incompetent and irreparable. PDF Ulnar Collateral Ligament Repair With Augmentation Rehabilitation Protocol Restrictions: No heavy lifting greater than 0 lbs. Ulnar collateral ligament injury in the elbow: current trends for 104 0 obj <>/Filter/FlateDecode/ID[<33B8DE36AB984B418169C7A4E24F203B><19F8EE0B324BFE44BA1CA95B759557F5>]/Index[79 50]/Info 78 0 R/Length 117/Prev 108309/Root 80 0 R/Size 129/Type/XRef/W[1 3 1]>>stream 0 <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 4 0 obj Diagnosis s/p RIGHT/LEFT UCL Repair with Internal Brace Date of Surgery_____ Frequency: ____ times/week Duration: _____ Weeks Week 1: Elbow is immobilized in Hinged Elbow Brace at 75 degrees flexion (7 - 10 days), wrist free, in sling. 2 0 obj Educate the patient on anti edema management. -Aggressive thumb active motion -The use of the internal brace makes for a very stable construct -AROM and PROM of thumb CMC and IP -No pinching/grabbing/lifting . ?3U,a_~`XRUWcQT2r?B73pgry.v3}w/2\Fz?6-SHK PXUU9:!$\@j)b;}r% /5 V5uz @ TY}]7KX75F1"3#TZLY|A/+{gc_?olhfGmHwiiB%"=CH$ai-`75 gdkZ_ 15 The results of this study suggest that the technique of augmented UCL repair with internal brace replicates failure strength of the . The triangular fibrocartilage complex (TFCC) is an important stabilizer of the distal radioulnar joint (DRUJ). endstream endobj startxref hWmo6+KI A ;WcIZ2LVaj%%u70y{l800`$p(AI6GBNP8S,CCrJcr\) 6,15,19,20,24,29 First described by Frank Jobe in 1986, the procedure has undergone significant evolution . PDF Dr. Allen Thumb UCL Reconstruction Rehabilitation Protocol The anti edema management will continue for several weeks. 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). (} oA%Yv:JzFQA 0X"5o A%U- MLZ;?3%RO8?DnQN['y]{_5%x@iSt>K2! PDF Rehabilitation Guidelines for UCL Repair with Internal Brace. Ulnar Collateral Ligament Repair Protocol - Physical Therapy Haven Epub 2019 Mar 12. A recently developed UCL repair procedure with an internal brace, utilizing collagen tape, is gaining popularity. !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 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 V8FW At 10 to 12 weeks, return to . Duration: 01:52. 7-10 day post-op OT to fabricate a custom FA based thumb spica AROM of the wrist and IP of thumb PDF UCL/RCL Thumb MP Joint Repair Rehabilitation Protocol - Ortho Illinois endobj During this time, active ROM is started as well as light isotonic . %PDF-1.6 % Elevate, ice and modalities to reduce pain and inflammation . Thumb Collateral Ligament Injury - Hand - Orthobullets Thumb UCL Repair and Reconstruction With Internal Brace Ligament Augmentation Repair Ulnar collateral ligament (UCL) tears of the thumb are common injuries. 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. %%EOF 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 endobj Elbow Ulnar Collateral Ligament Repair with InternalBrace PDF Institute for Orthopaedic Surgery Its many uses has helped numerous athletes return back from their injuries quicker than ever. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> PDF Ulnar Collateral Ligament (Ucl) Repair Rehabilitation Protocol *`]hgTTS:MV{gXS&K|-3m Thumb UCL Repair- Early Mobilization This protocol is intended to provide the clinician with a . Postoperative protocol. 557 0 obj <>stream << /Length 5 0 R /Filter /FlateDecode >> H00:GCp#r x Right after the surgery, the elbow is secured in a brace at a 60- to 90-degree angle. 0 TREATMENT: Treatment consists of either a period of splintage or if completely torn,a repair of the ligament with an operation. REHABILITATION PROTOCOL: ULNAR COLLATERAL LIGAMENT REPAIR/RECONSTRUCTION RADIAL COLLATERAL LIGAMENT REPAIR/RECONSTRUCTION THUMB MP JOINT WITH INTERNAL BRACE A. J. Mencias, M.D. You are still advised to avoid gripping, grasping and twisting with your thumb. endstream endobj startxref Non-weight bearing to operative extremity. There was gross instability of the ulnar collateral . UCL Repair With Internal Bracing - The Wave of the Future? <> the thumb. Phone: 574.247.9441 Fax: 574.247.9442 www.sbortho.com REHABILITATION PROTOCOL: THUMB UCL/RCL REPAIR SAM FULLER, M.D. 3 0 obj 4 0 obj The length of each phase varies depending on each patient and depends on tissue healing and progression. PDF Brandon J. Erickson, MD Mackenzie Lindeman, ATC 176 3 - Rothman Ortho Key Timeframes: (Dr Meister/TMI Protocol) Plyometric Phase: 12-14 weeks. The athletes that were treated with UCL repair and internal . r e c . The UCL is the main ligament, located on the inner aspect at the base of the thumb, which stabilizes the metacarpophalangeal (MCP) joint. !V!B;nkGL#_cz5asG) 0<>;Qm4P]3@41oJ5i~o;sJvQv9f r4A-C -Z]>T]Fo Subsequently, the adductor pollicis aponeurosis and extensor mechanism are identified, incised, and retracted. Phase I - Maximum Protection: 0 to 7 Days: Immobilization in posterior splint at 60-90 of elbow flexion . PDF Rehabilitation s/p UCL Repair with Internal Brace endobj The rehabilitation protocol after a Ulnar Collateral Ligament Repair with Internal Brace surgery typically involves several phases. !-twF)rm16:M.J r]Sc]Oi~ 3 0 obj endobj Thumb UCL Repair with InternalBrace Ligament Augmentation This internal brace surgery was developed by surgical company Arthrex. K\'~8_c3(rKC-,9/$&nd#{:+H>>*/yGG`b9.`\z. '_'n}Zj #:qdAa C;wB.Cx/mu 3hf_u*m"ZeD!\4' (l{aef"];c4#P9G4e't\Y1AM)DmgT?G -rG" ojqQPy3e8AcR:N~ N :#1YGokb &h(TA(VG[H}FQ. Repair of the Thumb Ulnar Collateral Ligament With Suture Tape Practice this exercise for about 5 minutes. The InternalBrace <> 02M_+ ! <>/Metadata 83 0 R/ViewerPreferences 84 0 R>> stream Instruct the patient to begin active range of motion exercises of the thumb without stressing the UCL/RCL repair. See Tua at the University of Alabama, for examaple. Initiate Throwing: 14-16 weeks (3.22 Months for Comparison) Bullpens: 24 Weeks (5.52 Months) Live BPs: 30-33 Weeks . PubMed PMID: 30862273. <> 0 PDF Elbow Ulnar Collateral Ligament (UCL) Repair Rehabilitation Protocol &H<0LElM0i""(P f4G0 H2a`70&E00v$`?W r 49 0 obj <> endobj <> 1 0 obj q %PDF-1.6 % It's pretty neat to see how it has taken on a whole world of uses, including in the knee and ankle. POST-OPERATIVE WEEK 2. Injuries to the ulnar collateral ligament of the thumb metacarpophalangeal joint (gamekeeper's thumb). %%EOF They also showed that internal brace repair performs similarly to the docking reconstruction technique . k,/f&;}P7# Lg W*lwHOPC(LZc>XgI3j:][1/+YX-?p%"6_NaWFv%k]|{6e@Ij Revision Date: 10/29/2021. Orthop & Spo Med Op Acc J 3(1)- 2019. Ligament / Volar Plate CPT Codes. %PDF-1.7 |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. |C&K 0g-Pf4/.B{s. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 1 0 obj 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. PDF Rehabilitation Protocol: Thumb Ucl/Rcl Repair Sam Fuller, M.d. h!DWl{$A4L61)H}hJftyrI%kSQLc]5sbGP U_8v}9|(O(( qsMfGiICYL|*'VL+b% << /Length 5 0 R /Filter /FlateDecode >> 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 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 | <>>> 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 -Hand based thumb spica brace (comfort cool) . Tommy John vs UCL Repair Armored Heat fPD. Brace: Elbow ROM 30-100 Cryotherapy: Continue ice to elbow joint and graft site . 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>? &H+JIKv)ATPJ};CH 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 PDF Ulnar Collateral Ligament (UCL) Injury to the Thumb ,.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