Tommy John Surgery – Pediatric

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Tommy John surgery is a reconstruction of the ulnar collateral ligament (UCL) in the elbow. This ligament is commonly torn from repetitive throwing motions associated with athletic activity. The ulnar collateral ligament is a main stabilizing ligament in the elbow during the throwing motion.

What is it?

Tommy John surgery is a reconstructive surgery of the ulnar collateral ligament in the elbow. Damage to this ligament can occur from repetitive motion, often associated with sports like baseball. The preferred method of treatment for this injury is rest, ice, and physical therapy. However, not all patients respond to this treatment, and some athletes may seek a more immediate recovery. In that case, Tommy John reconstructive surgery may be a viable option.

What should I do to prepare?

The doctor will first need to determine where the tendon for this surgery will be taken from, either from another extremity in the patient or from a deceased donor.  After examining the patient and making this decision, the patient should make accommodations to be driven them to and from the surgery as they will be feeling effects from the anesthesia.  Both before and immediately after the surgery, the patient should refrain from eating and drinking.

What happens during the process?

A surgeon will take a tendon from another place in a patient’s body, or perhaps a donor tendon, for reconstruction. Surgeons drill tunnels in the ulna and humerus of the elbow. The tendon is passed through these tunnels. It is then woven into a pattern to reconstruct the ligament. To give the graft added strength, any remnants of the original ligament are attached to the tendon.

What are the risks and potential complications?

Like all surgical procedures, Tommy John surgeries carry risks and side effects. Risks and complications vary in severity, but include:

  • Damage to the ulnar nerve
  • Infection
  • Hematoma


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