Student: Lindsey Jensen
Mentor: Professor Gail Samdperil, Professor Jodi Ouellette and Professor Tara Stritch
Major: Athletic Training
Objective: To present a unique technique of repairing a UCL ligament in a collegiate men’s ice hockey player.
Background: A 23 year old male collegiate ice hockey player was diagnosed with having a complete rupture of his ulna collateral ligament of his elbow at the beginning of his season. The mechanism of injury was due to a traumatic valgus force in conjunction with an immediate “pop”, and a sharp tearing like pain. After being evaluated by the team’s athletic trainer the athlete he was referred to the team physician the following day. After diagnostic testing the athlete was told he would able to play the rest of the season as long as no neurological symptoms arose. He had to wear a metal hinge that was extracted from a knee brace and secured onto the medial aspect of his elbow with prophylactic taping, because the traditional hinge brace did not fit over his arm. The athlete was diagnosed with having a complete tear of the ulnar collateral ligament (UCL) due to the results of an MRI. Athlete was cleared to play just five days after his traumatic injury.
Differential Diagnosis: Ulnar nerve damage, Elbow subluxation
Treatment: The day after his traumatic injury the athlete received electric stimulation to help control pain and swelling. The athlete was instructed by the team physician to be taped and wear a hinge brace whenever on the ice for practice or a game; due to gross instability of his elbow. The athlete was given a TENS unit to take home and rehabilitation exercises throughout the season to help control pain and swelling. The athlete had reconstructive surgery of the ulna collateral ligament (Tommy John Surgery) at the end of the season before going home for the summer. He attended physical therapy throughout the summer in hope to return to full play in six to eight weeks.
Uniqueness: This particular reconstruction of the UCL was very unique because the physician needed to weave together the palmaris longus and gracilis tendons. Using this technique helped make the autograft stronger for the athlete to help prevent reoccurrence of injury in the future. Normally, this surgery only uses the Palmaris longus or the gracilis, very rarely both are needed let alone used.
Conclusion: Diagnostic tests showed the athlete having a complete rupture of the UCL. The athlete played the rest of the season wearing only a hinge for support while playing. Post season the athlete had a Tommy john surgery and went home for rehabilitation over the summer. After a great deal of hard work and dedication the athlete was able to return to playing ice hockey the following season. His physical therapist stated that he 90% of his goals that they set prior to rehabilitation were achieved with the exception of the occasional discomfort with palpation to his left medial elbow ligament complex.
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