Abstract
The figure of 8 reconstruction described by Dr. Frank Jobe was the first surgical technique for addressing ulnar collateral ligament injuries in throwing athletes. While this technique has undergone various changes throughout the years, the fundamental principles of this technique remain the same. This technique involves the creation of a series of drill holes in the ulna and humerus through which a graft is passed in a figure of 8 fashion, thus giving the technique its name. Recent studies have demonstrated over 80% excellent results with regard to return to play at the same level.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Jobe FW, Stark H, Lombardo SJ. Reconstruction of the ulnar collateral ligament in athletes. J Bone Joint Surg Am. 1986;68(8):1158–63.
Conway JE, Jobe FW, Glousman RE, Pink M. Medial instability of the elbow in throwing athletes. Treatment by repair or reconstruction of the ulnar collateral ligament. J Bone Joint Surg Am. 1992;74(1):67–83.
Smith GR, Altchek DW, Pagnani MJ, Keeley JR. A muscle-splitting approach to the ulnar collateral ligament of the elbow. Neuroanatomy and operative technique. Am J Sports Med. 1996;24(5):575–80.
Thompson WH, Jobe FW, Yocum LA, Pink MM. Ulnar collateral ligament reconstruction in athletes: muscle-splitting approach without transposition of the ulnar nerve. J Shoulder Elb Surg. 2001;10(2):152–7.
Lowe JB 3rd, Maggi SP, Mackinnon SE. The position of crossing branches of the medial antebrachial cutaneous nerve during cubital tunnel surgery in humans. Plast Reconstr Surg. 2004;114(3):692–6.
Greiwe RM, Bjerke-Kroll B, Ahmad CS. Medial collateral ligament reconstruction. Oper Tech Orthop. 2009;19(4):243–50.
Azar FM, Andrews JR, Wilk KE, Groh D. Operative treatment of ulnar collateral ligament injuries of the elbow in athletes. Am J Sports Med. 2000;28(1):16–23.
Olsen SJ 2nd, et al. Risk factors for shoulder and elbow injuries in adolescent baseball pitchers. Am J Sports Med. 2006;34(6):905–12.
Andrews JR, Timmerman LA. Outcome of elbow surgery in professional baseball players. Am J Sports Med. 1995;23(4):407–13.
Jones KJ, Osbahr DC, Schrumpf MA, Dines JS, Altchek DW. Ulnar collateral ligament reconstruction in throwing athletes: a review of current concepts. AAOS exhibit selection. J Bone Joint Surg Am. 2012;94(8):e49.
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):1193–205.
Cain EL Jr, Andrews JR, Dugas JR, Wilk KE, McMichael CS, Walter JC 2nd, et al. Outcome of ulnar collateral ligament reconstruction of the elbow in 1281 athletes: results in 743 athletes with minimum 2-year follow-up. Am J Sports Med. 2010;38(12):2426–34.
Petty DH, Andrews JR, Fleisig GS, Cain EL. Ulnar collateral ligament reconstruction in high school baseball players: clinical results and injury risk factors. Am J Sports Med. 2004;32(5):1158–64.
Griffith TB, Ahmad CS, Gorroochurn P, D’Angelo J, Ciccotti MG, Dines JS, Altchek DW, Camp CL. Comparison of outcomes based on graft type and tunnel configuration for primary ulnar collateral ligament reconstruction in professional baseball pitchers. Am J Sports Med. 2019;47(5):1103–10. https://doi.org/10.1177/0363546519831705. Epub 2019 Mar 21. PMID: 30896975.
Arner JW, Chang ES, Bayer S, Bradley JP. Direct comparison of modified jobe and docking ulnar collateral ligament reconstruction at midterm follow-up. Am J Sports Med. 2019;47(1):144–50. https://doi.org/10.1177/0363546518812421. Epub 2018 Nov 30. PMID: 30500269
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Electronic Supplementary Material
Ulnar tunnel creation. Drilling the two converging ulnar tunnels, anterior and posterior to the sublime tubercle (M4V 3919 kb)
Humeral tunnel creation. Drilling one of the two converging humeral tunnels on the anterosuperior medial epicondyle (M4V 4416 kb)
Graft passage through the humeral tunnels. The graft is in the ulnar tunnels, and the tagged end is passed from distal to proximal through the humeral tunnels, followed by repassing it proximal to distal along with a suture loop (M4V 42012 kb)
Graft passage to create figure of 8 configuration. The tagged end of the graft is passed through the ulnar tunnels from posterior to anterior using a previously passed suture loop (M4V 7961 kb)
Final graft passage through the humeral tunnel. The free end of the graft being passed from proximal to distal through the humeral tunnel with a previously passed suture loop (M4V 10306 kb)
Intraoperative valgus stress test. Valgus instability in the ulnar collateral ligament (UCL) deficient ulnohumeral joint (M4V 3021 kb)
Rights and permissions
Copyright information
© 2021 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Wanich, T., Choi, J.H., Yocum, L.A. (2021). Figure of 8 Technique and Outcomes. In: Dines, J.S., Camp, C.L., Altchek, D.W. (eds) Elbow Ulnar Collateral Ligament Injury. Springer, Cham. https://doi.org/10.1007/978-3-030-69567-5_21
Download citation
DOI: https://doi.org/10.1007/978-3-030-69567-5_21
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-69566-8
Online ISBN: 978-3-030-69567-5
eBook Packages: MedicineMedicine (R0)