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Tommy John Surgery

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Baseball players and fans call it Tommy John surgery, after the pitcher who was the first to have the surgery 29 years ago. By any designation, it is one of the major advancements in sports medicine in the last quarter century. Technically it is a ulnar collateral ligament replacements procedure. Pitching overhand is a particularly stressful motion; the strain it puts on a player's joint is commonly injurious. Pitchers such as Kerry Wood, Matt Morris, John Smoltz, Mariano Rivera, Tom Gordon, and Eric Gagne all have a four inch scar on their pitching arms as evidence of this career saving surgery. These players typically perform as well, if not better, after the operation and have stronger arms, with radar gun readings to match. …show more content…

Usually this tendon will be harvested from the leg that is not used as the plant foot in the pitcher's delivery. The removal of either of these tendons has a negligible effect on function. Then, the surgeon opens up the elbow. In the original procedure, Frank Jobe used a large incision to get exposure to the joint. For an idea of the size of this incision, hold your right arm out from your body with your palm pointed upwards. With your other hand, feel along the inside of the elbow until you can find what feels like a hard round nub. That's the proximal end of your ulna bone. The incision would have taken place along the inside of the arm, beginning several inches above the elbow and ending several inches below. As Dr. Akizuki explains, "In order to get exposure to the joint you used to have to detach the entire flexor attachment [the muscles that flex the elbow--you can feel those muscles by feeling along the incision site]. You used to just fillet that open." Once inside the elbow the unlar nerveis recognized, lifted out, and moved to provide greater access to the joint. This is the "funny bone" nerve and it runs inside the ulnar groove. With the muscle separated and the ulnar nerve safely out of the way, the surgeon would then locate the damaged ligament. First scraping out the damaged tissue, then the next step is to drill tunnels in the

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