Ulnar nerve transection during Tommy John surgery: novel findings and approach to treatment.

Abstract

While iatrogenic injuries to peripheral nerves in sports-related surgeries are rare, the morbidity of a peripheral nerve injury can be substantial, particularly in the young, active patient population [8]. Medial ulnar collateral ligament (UCL) reconstruction with tendon graft (Tommy John surgery) is a safe and effective operative intervention in treating medial elbow instability in overhead throwing athletes [6, 9] and complications are rare. Ulnar nerve neurapraxia is the most commonly recognized nerve complication [4]. However, median nerve transection during tendon graft harvest has been reported [5, 7, 10, 11, 13]. We report the first documented case of a complete ulnar nerve transection following UCL reconstruction and present a novel surgical intervention to address this serious complication.