UCL Repair — Thumb UCL Repair — Early Mobilization

UW Health Orthopedic Surgery; UnityPoint Health - Meriter Rehabilitation

Weight-Bearing

NWB surgical UE

Key Restrictions

No lifting/pushing/pulling >5 lbs involved UE; no WB involved UE; no aggressive pinching/gripping; no UCL lateral stress

Timeline & Phases

Phase I (10–14 days): hand-based thumb spica (MP protected from RU deviation) all time except hygiene/exercises; active wrist/finger/thumb IP A/AA/PROM; thumb MPJ AROM; composite CMC/MP AROM; gentle palmar and radial abduction without UCL stress; wound/scar/edema management | Phase II (4 wks): light functional use without orthosis; pain-free isometric strengthening; orthosis all time except bathing/exercises/light-moderate activities | Phase III (6 wks): PROM avoiding lateral stress to MPJ; pain-free concentric grip/key pinch; wean orthosis, night + heavy activities | Phase IV (8 wks): continue strengthening; functional grip/pinching activities; full ROM; D/C orthosis (wear for heavy; static/dynamic progressive splint if ROM very limited) | Phase V (10–12 wks): no restrictions; work/leisure strengthening; D/C orthosis

Notes

Post-op for ≥50% UCL tear or Stener lesion; goal: stable pain-free thumb MP ROM; thumb MPJ AROM begins at 10–14 days vs. 4 weeks in Conservative protocol; developed collaboratively by UW Health and UnityPoint Health - Meriter Rehabilitation