Andrews ulnar collateral ligament reconstruction. A, Harvest of palmaris graft. B, Medial antebrachial cutaneous nerve visible in distal third of exposure. C, Dissection of ulnar nerve from the cubital tunnel and mobilization with a vessel loop. D, Flexor digitorum profundus muscle belly elevated to expose the native ulnar collateral ligament, which is directly below the scalpel blade. E, Drilling of ulnar tunnels on either side of the sublime tubercle, perpendicular to the joint surface. F, Passage of graft through the ulnar tunnel. G, Drilling of the humeral tunnel from distal to proximal, starting at the native insertion of the ulnar collateral ligament onto the humerus. H, Placement of a curet in the first humeral tunnel while second tunnel is drilled. I, Graft sewn together between the humeral and ulnar tunnels to increase tension within the graft and re-create the course of the native ligament. (From Andrews JR, Jost PW, Cain EL: The ulnar collateral ligament procedure revisited: the procedure we use, Sports Health 4:438–441, 2012.) SEE TECHNIQUE 47.14.