Elbow ligament repair/reconstruction
Elbow ligaments on the medial and lateral sides of the elbow are approached differently. The medial ligament, the UCL or Tommy John ligament, gets all of the hype because it pertains to throwers. Most people don't need this ligament to function in day to day life. On the other hand, the LUCL or lateral ligament is key to stability in day to day function of the elbow. This ligament can be injured in a simple elbow dislocation and never become competent or in the setting of an elbow fracture dislocation and require repair to obtain stability of the elbow.
1-10 days: The elbow is typically splinted in flexion and pronation for repair or reconstruction of the lateral side. Ice frequently and avoid NSAIDs and nicotine products. Keep dressing clean and dry.
2-4 weeks: Hinged elbow brace 30-90 degrees, in pronation for lateral work. Chronic injury such as old instability will be easier to obtain full motion than the traumatic fracture dislocation. Continue ice. Remove brace for hand and wrist ROM three times daily. Avoid varus stress to the elbow even in the brace, comprised of shoulder abduction and internal rotation.
4-6 weeks: Start increasing to flexion and extension blocks by 10 degrees weekly until the end of week 6 the brace is unlocked. Continue with the hand in pronation.
6-12 weeks: Continue hinged elbow brace full ROM. May initiate elbow flexion/extension and wrist strengthening. Avoid varus stress.
3-6 months: Discontinue hinged elbow brace. Continue arm strenthening. May return to work but avoid varus stress to the elbow. Throwers may initiate a graduated throwing program.
6-9 months: May return to sport. Depending on level of contact, lower profile hinged elbow brace may be recommended.
9+ months: May return to throwing sports and slowly start varus stress activities.
1-10 days: The elbow is typically splinted in flexion and pronation for repair or reconstruction of the lateral side. Ice frequently and avoid NSAIDs and nicotine products. Keep dressing clean and dry.
2-4 weeks: Hinged elbow brace 30-90 degrees, in pronation for lateral work. Chronic injury such as old instability will be easier to obtain full motion than the traumatic fracture dislocation. Continue ice. Remove brace for hand and wrist ROM three times daily. Avoid varus stress to the elbow even in the brace, comprised of shoulder abduction and internal rotation.
4-6 weeks: Start increasing to flexion and extension blocks by 10 degrees weekly until the end of week 6 the brace is unlocked. Continue with the hand in pronation.
6-12 weeks: Continue hinged elbow brace full ROM. May initiate elbow flexion/extension and wrist strengthening. Avoid varus stress.
3-6 months: Discontinue hinged elbow brace. Continue arm strenthening. May return to work but avoid varus stress to the elbow. Throwers may initiate a graduated throwing program.
6-9 months: May return to sport. Depending on level of contact, lower profile hinged elbow brace may be recommended.
9+ months: May return to throwing sports and slowly start varus stress activities.