Ulnar collateral ligament reconstruction in athletes using a cortical button suspension technique

Chad Myeroff, J. Logan Brock, G. Russell Huffman

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Background: A variety of techniques currently exist for ulnar collateral ligament (UCL) reconstruction in symptomatic overhead athletes, all with the potential complication of fracture about the humeral or ulnar tunnels. Far cortical button fixation is a reproducible, biomechanically attractive option; however, no clinical series has been published on this technique to date. This study reports the clinical outcomes, with minimum 2-year follow-up, of a dual far cortical button suspension technique for UCL reconstruction in athletes. Methods: A retrospective evaluation was performed of 23 consecutive athletes who underwent UCL reconstruction with the use of ulnar and humeral-sided far cortical button fixation with minimum 2 years of follow-up. Data were collected from electronic medical records and patient telephone calls. The primary outcome was return to sport. Secondary outcomes included Disabilities of the Arm, Shoulder and Hand score, range of motion, and complications. Results: We included 23 athletes with a mean follow-up of 47.2 months (range, 24-81 months). Autograft was used in 22 patients (16 palmaris, 6 gracilis, 1 semitendinosus, and 1 gracilis allograft). Overall, 82.6% (19 of 23) of patients returned to sport. At final follow-up, the average Disabilities of the Arm, Shoulder and Hand score was 3.8, and range of motion averaged 0° to 140° with 87% (20 of 23) of patients achieving full motion. The visual analog scale score improved from 3.8 preoperatively to 0.2 at the final follow-up (P <.0001). There was 1 reconstruction failure. Conclusions: The humeral and ulnar far cortical button suspension technique provides a new UCL fixation option with theoretically lower concern for tunnel fracture and with predictable return to sport and good functional outcomes.

Original languageEnglish (US)
Pages (from-to)1366-1372
Number of pages7
JournalJournal of Shoulder and Elbow Surgery
Issue number8
StatePublished - Aug 2018
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2018 Journal of Shoulder and Elbow Surgery Board of Trustees


  • Case Series
  • Level IV
  • Tommy John
  • Treatment Study
  • UCL
  • Ulnar collateral ligament reconstruction
  • cortical button suspension
  • docking technique
  • elbow instability
  • thrower


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