Question:Our 26-year old son is a professional baseball player with a problem. He tore his medial collateral ligament during practice. He had surgery to repair the problem, but it left him with a pinched nerve from scar tissue. Should he have a second operation to free up the nerve? We just don't know how to advise him.
Answer:Reconstruction of medial collateral ligament tears can be very complicated. If there's been a long history of pain before the operation, the ligament can be scarred and fibrotic. The nerve can get bound down in the soft tissues as well.
The same thing can happen after a primary (first) surgery. Pain, numbness, and tingling are the first symptoms of a nerve problem. Surgery to free the nerve requires meticulous dissection. Nerves covered in scar tissue can be damaged trying to remove the fibrotic tissue from around them.
The surgeon will try to use the same incisions as in the first surgery. This will help reduce further scarring. If there are any bone spurs pressing on the nerve, these will be removed. Most often, the nerve is transposed (moved) so that nothing is pressing on it or compressing it.
It is possible to return to play after surgery of this type. Recovery may include physical therapy to help with painful symptoms. The therapist will instruct the athlete in exercises that will keep the tendons and nerve gliding freely and smoothly.Joshua S. Dines, MD, et al. Revision Surgery for Failed Elbow Medial Collateral Ligament Reconstruction. In The American Journal of Sports Medicine. June 2008. Vol. 36. No. 6. Pp. 1061-1065.
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