Ulnar collateral ligament repair surgery

UCL repair surgery, or Tommy John surgery, is a procedure to treat an injury to the UCL, the soft tissue that connects the bones of the thumb and provides stability to the thumb joint. In this minimally invasive technique, the surgeon makes a small cut over the back of the thumb joint and examines the area around the injury for damage. The surgeon then reattaches the UCL and uses a suture anchor or screw to hold it in place as it heals.

Surgery is most effective when performed within the first few weeks following injury. Untreated, UCL injuries can lead to chronic pain and instability, diminished hand function and early onset arthritis.


The ulnar collateral ligament, located at the base of the thumb joint, helps stabilize the thumb so it doesn’t bend too far. The ligament is attached to the bones on either side of the thumb joint. A UCL injury occurs when the ligament is stretched or torn.

When is surgery recommended?

Historically, the recommended treatment for a UCL injury involved immobilizing the thumb in a cast for four to six weeks. This option may work if the ligament injury is minor. Today, in the majority cases, surgery to repair the UCL is the treatment of choice.

What is the recovery time?

UCL repair surgery is an outpatient procedure and patients go home the same day. Most wear a soft splint for the first week and then spend four to six weeks in a cast to allow the ligament to heal. Rehabilitation with a certified hand therapist helps regain strength and stability. Patients generally return to daily activities and work within a few weeks, often with a splint to avoid stressing the UCL too much. Return to sports usually takes about three to four months.

Surgeons who perform UCL surgery

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