The Orthobullets Podcast Podiums⎪Shoulder & Elbow⎪UCL Primary Repair
Jul 18, 2025
George Paletta, an esteemed orthopedic surgeon, shares insights on the intricate process of UCL primary repair surgery. He discusses comprehensive techniques tailored for young athletes suffering from UCL injuries. Listeners will learn about crucial aspects like incision placement and the rationale behind different repair methods. Paletta's expertise sheds light on the importance of these techniques in ensuring effective recovery and return to sports, making this discussion invaluable for medical professionals and sports enthusiasts alike.
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Surgical Approach for UCL Repair
- Use a 6 cm incision from the medial epicondyle distally to access the UCL for repair.
- Identify and carefully expose the UCL by splitting the flexor pronator between its anterior two-thirds and posterior one-third.
Distal UCL Repair Technique
- Drill the distal hole about 12 mm distal to the ulno-humeral joint in the sublime tubercle.
- Place the anchor and pass sutures through the ligament leaflets, tying at 60° elbow flexion with neutral forearm and slight varus to close the tear.
Proximal Anchor and Internal Brace Placement
- Drill a 10 mm humeral tunnel in the medial epicondyle staying within the column to avoid ulnar nerve exposure.
- Create two converging Y-shaped drill holes and pass sutures for internal brace limbs through them, then tie the internal brace tightly at 60° flexion.