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UCL (Tommy John) Reconstruction


What is Tommy John surgery?

Tommy John surgery is another name for ulnar collateral ligament (UCL) reconstruction. The procedure is named after Tommy John, a former pitcher for the Los Angeles Dodgers who first underwent the surgery in 1974.

The UCL is a thick section of ligament tissue that provides stability to the elbow during throwing. An injury to your UCL can range from a stretch to a full-thickness tear. These injuries most commonly occur gradually over time from repetitive injury due to throwing.

What causes UCL injuries?

In many cases, UCL injuries are the result of sports-related activities where repetitive motion is common, such as when pitching or throwing a baseball. UCL damage can also result from elbow injuries from auto accidents, falls, and elbow dislocations.

What are the symptoms of UCL injuries?

Common symptoms of UCL injuries include pain localized to the inner part of the elbow during throwing. Many throwers also complain of decreased velocity and poor accuracy. In some patients, a UCL injury also causes tingling in the ring and small finger.

What happens during Tommy John surgery?

Dr. Carofino has extensive training and experience with Tommy John reconstruction surgery.  He serves as the team physician for the Norfolk Tides. He also provides care for two college baseball teams (Norfolk State and Bryant & Stratton), as well as countless youth baseball players throughout Virginia Beach, Chesapeake, and Norfolk, Virginia.

As a result, Dr. Carofino routinely evaluates both professional baseball players and Little Leaguers for Tommy John injuries. He confirms the diagnosis using an MRI and a thorough physical examination before recommending surgery.

If you need Tommy John reconstruction surgery, Dr. Carofino administers general anesthesia for your comfort. He uses an open incision to access the surgical site. Using either your own tissue or tissue from a donor, Dr. Carofino reconstructs the ligament.

In many cases, if Dr. Carofino uses your own tissue, he opts for the palmaris longus tendon from your forearm. This tendon is anatomically similar to your UCL and offers less risk for rejection by your immune system than donor tissue.

What can I expect after Tommy John surgery?

Following your surgery, you can expect to wear a hinged elbow brace for six to eight weeks to allow for proper healing. Once the surgery site has healed, Dr. Carofino may recommend physical therapy to improve your range of motion and strengthen your elbow muscles.

It can take up to a year until you can return to your normal activities, including sports, to ensure your reconstructed ligament has completely healed.

To learn more about the benefits of Tommy John surgery, schedule a consultation with Dr. Carofino online or by phone.


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