Often referred to as Tommy John surgery (a nod to the former Los Angeles Dodgers pitcher who was the first patient to undergo the procedure), ulnar collateral ligament (UCL) reconstruction is performed to repair ligament damage in the elbow joint. Located on the inner part of the elbow, the UCL connects the upper arm bone (humerus) to one of the two long forearm bones (ulna).
Tommy John injuries are common among baseball pitchers and other athletes who participate in sports that involve repetitive overhead arm movements. Over time, the stress of these movements can cause tears to form in the UCL, affecting the ability of the ligament to keep the bones securely connected.
What Are the Symptoms of a Tommy John Injury?
UCL tears often worsen over time. However, with an early diagnosis, it may be possible to avoid Tommy John surgery. Some common signs to watch for include:
- Pain, swelling, and bruising in the inner side of the elbow
- Stiffness and an inability to fully straighten the arm
- A sensation of instability or looseness in the elbow joint
- Decreased range of motion and impaired throwing ability
- Tingling or numbness in the pinky and ring fingers (due to irritation of the ulnar nerve)
Treatment & Recovery
Tommy John injuries can vary in severity. In most cases, however, treatment begins conservatively with rest, ice applications, and nonsteroidal anti-inflammatory drugs (NSAIDs).
If nonsurgical treatment does not provide sufficient symptom relief, Tommy John surgery may be considered. During this procedure, a surgeon reconstructs the UCL using a tendon graft from the patient’s forearm, wrist, hip, hamstring, knee, foot, or toe. After creating attachment points in the ulna and humerus, the surgeon weaves the grafted tendon into the bones. Complete recovery from Tommy John surgery can take up to a year, but many patients are able to resume their sport at or above the level they were playing prior to surgery.
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