Doctor checking patient with elbow to determine the cause of illness.

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

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