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Thumb Ulnar Collateral Ligament Tear Repair

Alexander D. Selsky, BS1; Asif M. Ilyas, MD, MBA, FACS2
1Lake Erie College of Osteopathic Medicine, Bradenton Campus
2Rothman Institute at Thomas Jefferson University

1. Introduction and Surgical Approach

2. Incision and Dissection to Extensor Mechanism

3. Identification and Preservation of Branches of Radial Sensory Nerve

4. Identification of Possible Stener Lesion

5. Exposure of UCL Footprint and MP Joint Capsule

  1. Release Adductor Aponeurosis Longitudinally
  2. Elevate Extensor Mechanism Dorsally

6. Mobilization of UCL and Confirmation of Tendon Length

7. Placement of K-Wire in MP Joint

8. UCL Repair

  1. Prepare Footprint with Rongeur
  2. Place Suture Anchor
  3. Primary Repair of UCL to Footprint
  4. Augment Repair to Incorporate MP Joint Capsule
  5. Inspect and Confirm Repair and Reinforcement
  6. Reinforce Repair Further with Sutures Between UCL and MP Joint Capsule

9. Closure