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Ulnar Collateral Ligament (UCL) Repair with Internal Brace

UCL repair with an internal brace is a surgery that involves the use of collagen-coated tape (internal brace) surgically placed at the site of the damaged UCL ligaments. It provides better resistant and a faster recovery compared to traditional reconstruction surgery that involves the use of graft tissue from your body.


The ulnar collateral ligament (UCL), also called the medial collateral ligament, is located on the inside of the elbow and connects the ulna bone to the humerus bone. It is one of the main stabilizing ligaments in the elbow, especially with overhead activities such as throwing and pitching.  

Ulnar Collateral Ligament (UCL) Injuries

UCL injuries are usually caused by repetitive overhead throwing such as in baseball. The stress of repeated throwing on the elbow causes microscopic tissue tears and inflammation. With continued repetition, the UCL can tear preventing the athlete from throwing at significant speed. If untreated, it can end an athlete’s professional career. 

UCL injury may also be caused by direct trauma such as with a fall, car accident, or work injury. Other causes include any activity that requires repetitive overhead motion of the arm such as tennis, pitching sports, fencing, and painting.

Indications for UCL Repair with Internal Brace

UCL repair with an internal brace is indicated for the fast recovery of UCL injuries in athletes. It restores a full range of motion in the elbow for the athlete to return quickly back to sports.

Preparing for the Surgery

  • Your doctor will assess the symptoms and take a medical history. 
  • Physical examination of your elbow will be performed. Imaging studies such as X-ray, MRI, or CT-scan will be ordered. 
  • Fluoroscopy may be ordered to help diagnose the injury. 
  • Talk to your doctor about the medicines you are taking prior to the procedure. Inform your doctor if you are allergic to any medicines or anesthesia. 
  • Be prepared for an overnight stay at the hospital and arrange for someone to drive you home the next day.

Procedure of UCL Repair with Internal Brace

The surgery involves the following steps:

  • You are positioned to lie on your back (supine position)
  • You may be given general and regional anesthesia.
  • An incision is made near the medial epicondyle of your elbow towards the UCL ligaments.
  • Your surgeon performs debridement of damaged tissues.
  • Suture anchors are placed at the point of origin of the ligament. 
  • A collagen-coated (internal brace) tape is placed. 
  • Care is taken to avoid damage to nerves.
  • The internal brace is attached to the bone surfaces with special sutures.
  • The incision is closed with sutures and covered with sterile dressings.

Recovery after Surgery

Your doctor will prescribe pain medicines as needed. Your elbow is supported with a sling for about 6 weeks. Your physical therapist will teach specific exercises to help you recover sooner.

Risks and Complications

Complications are rare but can include:

  • Infection
  • Limited range of motion
  • Nerve damage 
  • Elbow instability