Inverted Mattress Knotless Repair of Medial Ulnar Collateral Ligament Avulsion Injury Using Flat Braided Suture Internal Brace

Abstract

Direct repair of ulnar collateral ligament (UCL) injuries with suture augmentation has been successful in properly selected patients lacking chronic attritional wear of the medial elbow. Described is a Speed-Fix technique for direct UCL repair using SutureTape, with InternalBrace augmentation. The Speed-Fix repair technique uses an inverted mattress knotless repair with a knotless SwiveLock anchor and FiberTape suture, which allows for theoretical compression at the repair site. However, the proposed technique uses a 0.9-mm SutureTape to decrease tissue pullout and an InternalBrace to provide time-zero repair stability. For patients with ulnar nerve pathology, a pronator mass elevation was used for exposure, whereas a muscle-splitting approach was used for those without ulnar nerve pathology. With this technique, all patients were able to return to sport and were able to do so at an accelerated rate without repair failures.