UCL Reconstruction/Repair

POSITIONING:

Supine, operative arm on Parker table; If gracilis autograft, secure non-operative leg

EQUIPMENT:

Bovie 20/20

Bipolar 12

Bair hugger to lower body

TOURNIQUET:

Arm – 18” with 4” webril and clear 1010 (as high as possible on the arm)

Gracilis autograft – 30” with 6” webril and clear 1015

MEDICATIONS:

Clindamicin 600 mg in 500 ml NS

Decadron 10 mg (to anesthesia)

If doing gracilis autograft🡪 LTA Kit: 4% Lidocaine (4 mL) (https://aam.ucsf.edu/article/topical-airway-anesthesia-devices)

SPLINT:

5×30 Plaster, 15 sheets open, 5 sheets folded, sling

PREP:

Cover operative site with a lap pre-soaked in 3% hydrogen peroxide for 7 minutes

Chloraprep x2

DRAPING:

¾ sheet x2 – one covering chest to feet, one oriented chest to head

Blue towel around the arm just distal to clear 1015 secured with an allis clamp

Stockinette to the mid-forearm

Hand drapes

Coband around stockinette – keeping thumb out and hand flat

**Additional chloraprep to apply after final draping completed

SUPPLIES

Drapes

• Hand pack
• Table drape
• 1010 drape
• X-long gown
• Pack of Towels (x2)
• Ortho linen pack

Blades/Needles

• 18G spinal needle
• 10 Blade
• 15 Blade (x4)

Peel Pack

• Drill and batteries (x2)
• Bipolar forceps
• 2.4 mm guide pin

Sutures

• #1 Ethibond (x3)
• 0 Vicryl CT-2 (x3)
• 2-0 Vicryl CT-2 (x2)
• 3-0 Vicryl CT-2 (x4)
• 2-0 Prolene FS 
• 0 FiberWire T-4 (x3)
• If repair
  • Arthrex SutureTape (x1)
  • Arthrex TigerLoop (x1) and FiberLoop (x1)
• Small cutting free needle
• Large free needle

Instruments

• Arthrex Elbow UCL Reconstruction Tray 
• If a repair
  • Arthrex UCL repair kit with Internal Brace

Implants

• 2.6 mm Arthrex biceps button (Available)

Dressings

• Steri strips (x3)
• 4×4
• Xeroform
• ABD (x3)
• 4” Bias (x2)
• 4” Webril (1 for tourniquet)
• 1” cloth tape, splint, sling

Contralateral Palmaris

Supplies

• Chloraprep (x2)
• Small chloroprep
• Hydrogen peroxide
• 4” Coban
• 4” Esmark

Drapes

• Extremity sheet
• Medium sheet
• Impervious stockinette
• Mayo stand cover

Sutures

• 3-0 Vicryl CT-2
• 3-0 Nylon PS-2 (x2)

Dressings

• 4” Bias (x2)

Gracilis Autograft

Supplies

• Chloraprep (x2)
• Small chloraprep
• Hydrogen peroxide
• LTA kit
• 4” coban
• ¼ Penrose
• 6” Esmark

Drapes

• Extremity sheet
• Medium sheet
• Impervious stockinette
• Mayo stand cover
• Impervious U drape

Peel Pack

• Tendon stripper (hook)

Sutures 

• 2-0 Prolene FS-1
• 2-0 Vicryl CT-2
• 3-0 Vicryl CT-2

Dressings (To Pull)

• ABD (x2)
• 6” bias (x2)
• Long ace wrap