This document, authored by Jared T. Lee, MD, outlines a rehabilitation plan for patients following a Thumb UCL (Ulnar Collateral Ligament) Repair or Reconstruction.
The document details four phases of rehabilitation, each with specific:
- **Restrictions:** Guidelines for splint usage (thumb spica splint, then hand-based Exos brace), weight-bearing restrictions (no weight bearing with the involved upper extremity in early phases), and activity limitations (no pinching or grabbing initially, no lifting more than 5 lbs).
- **Therapeutic Exercises:** Prescribed activities focusing on range of motion (ROM) for fingers, elbow, and shoulder, suture tail trimming (if needed), scar massage/desensitization, active, passive, and active assisted ROM for the wrist, CMC joint, and DP joint, gentle passive ROM of the MP joint (no valgus stresses), intrinsic hand strengthening, fine motor activity, and progressive resistance exercises/strengthening.
- **Goals:** Objectives for each phase, such as reducing swelling and edema, minimizing pain, retarding muscle atrophy, protecting the surgical repair, avoiding stiffness, progressing ROM, beginning neuromuscular control, improving power and endurance, and progressing functional activities.
- **Criteria for Discharge:** Include less than 10% strength deficit, limb similarity index of 90% or greater, 45/50 on biomechanical functional tests (if performed), and no pain or complaints of instability.
The phases progress from initial post-operative care with a thumb spica splint to full return to activity and sports/labor work, with increasing exercise intensity and functional demands. The document also specifies avoiding sustained, heavy pinch and stress across the UCL until 16 weeks post-op.