Abstract
Prior to Jobe’s description of a reconstruction technique for ulnar collateral ligament (UCL) insufficiency, the injury was career ending. Despite successful results in about 70 % of cases, concerns with elevation of the flexor-pronator mass, ulnar nerve complications and relatively large bone tunnels in the medial epicondyle of the humerus led to modifications to Jobe’s technique. One of the most novel modifications was the “docking technique.” Differences included: (1) arthroscopic evaluation and management, when indicated, of concomitant intra-articular pathology, (2) maintenance of the ulnar nerve in situ unless symptoms specifically indicate transposition, (3) use of a muscle splitting approach through the flexor mass, and (4) “docking” of the graft into a humeral socket. Ulnar preparation remained the same as originally described Jobe. These modifications facilitated improved graft tensioning while minimizing the number of large tunnels drilled in the relatively small medial epicondyle. Intraoperative morbidity was minimized by the muscle-splitting approach and the reservation of ulnar nerve transposition only when indicated based on preoperative exam. Clinical results have been excellent using this technique, and it is our preferred technique for UCL reconstruction.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Jobe FW, Stark H, Lombardo SJ. Reconstruction of the ulnar collateral ligament in athletes. J Bone Joint Surg Am 1986;68:1158–63.
Rohrbough JT, Altchek DW, Hyman J, Williams III RJ, Botts JD. Medial collateral ligament reconstruction of the elbow using the docking technique. Am J Sports Med 2002;30:541.
O’Driscoll S, Lawton R, Smith A. The moving valgus stress test for medial collateral ligament tears of the elbow. Am J Sports Med. 2005;33(2):231–9.
Dodson CC, Thomas A, Dines JS, Nho SJ, Williams III RJ, Altchek DW. Medial ulnar collateral ligament reconstruction of the elbow in throwing athletes. Am J Sports Med 2006;34(12):1926–32.
Koh JL, Schafer MF, Keuter G, Hsu JE. Ulnar collateral ligament reconstruction in elite throwing athletes. Arthroscopy 2006;22(11):1187–91.
Paletta GA, Wright RW. The modified docking procedure for elbow ulnar collateral ligament reconstruction. Am J Sports Med 2006;34(10):1594–8.
Bowers A, Dines J, Dines D, Altchek DW. Elbow medial ulnar collateral ligament reconstruction: clinical relevance and the docking technique. J Shoulder Elbow Surg. 2010;19(2S):110–7.
Vitale MA, Ahmad CS. The Outcome of Elbow Ulnar Collateral Ligament reconstruction in overhead athletes: a systematic review. Am J Sports Med. 2008;36(6):1193–2005.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Electronic supplementary material
Rights and permissions
Copyright information
© 2015 Springer Science+Business Media New York
About this chapter
Cite this chapter
Dines, J., Berger, A., Altchek, D. (2015). Ulnar Collateral Ligament Reconstruction: Docking Technique. In: Dines, J., Altchek, D. (eds) Elbow Ulnar Collateral Ligament Injury. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-7540-9_17
Download citation
DOI: https://doi.org/10.1007/978-1-4899-7540-9_17
Published:
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4899-7539-3
Online ISBN: 978-1-4899-7540-9
eBook Packages: MedicineMedicine (R0)