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It was originally described by CS Campbell 1 and the mechanism of injury is forced radial deviation abduction. Patients can present with a broad range of ulnar instability. InStener described a series of patients with complete rupture of the UCL, and during surgery he found the adductor aponeurosis interposed between the distally avulsed UCL and its insertion at the base of the thumb.
It is an often-encountered injury and can lead to chronic pain and instability when diagnosed incorrectly. This article provides a review of the relevant anatomy, the correct method of physical examination and the options for additional imaging and treatment with attention to possible pitfalls. The literature search was conducted on PubMed in the week of 5 November
Feb 23, Injuries to the thumb ulnar collateral ligament UCL are common. Failure to address the ensuing laxity of the metacarpophalangeal joint can lead to compromised grip and pinch, pain, and ultimately osteoarthritis. Instability to valgus stress with the lack of a firm end point is a strong indicator of complete rupture of the UCL.
AP and lateral radiographs showed a fracture at the base of the proximal phalanx of the thumb Figure 1. A small osseous fragment was noted on the ulnar side of the first metacarpophalangeal MCP joint Figure 2. The term was initially used to describe chronic occupational injuries to the ulnar collateral ligament to gamekeepers in Scotland because of their methods used to kill rabbits.
A Stener lesion is a type of traumatic injury to the thumb. It occurs when the aponeurosis of the adductor pollicis muscle becomes interposed between the ruptured ulnar collateral ligament UCL of the thumb and its site of insertion at the base of the proximal phalanx. No longer in contact with its insertion site, the UCL cannot spontaneously heal.
European Radiology. The gamekeeper's or skier's thumb is a very common injury. Nondisplaced tears of the ulnar collateral ligament of the thumb UCL may be treated conservatively.
The breaking of the unlar collateral ligament first metacarpophalangeal joint is one of the most frequent injuries sustained from sporting activities, and can result in pain and instability in the thumb. This injury is caused by a force that pushes the thumb away from the fingers, developing in pain, bruising and swelling in the area, and can be caused from a single force or maybe due to repeated forces. The radial collateral ligament is found on the other side of the thumb. It can tear, but this is not as common as a tear on the ulnar side of the thumb.
Our teaching methodology is specifically designed to maximize your daily impact across these 4 areas:. Between them they encompass 30 separate joints which are largely similar to one another, aiding in diagnosis, but as any extremity surgeon will tell you the gamut of clinical presentations is surprising and can be confounding. These surgeons and specialists, like the baristas in your local coffee shop, have their own language to describe the variations — trigger injuries, beak ligaments, boutonniere deformities, pulley mechanisms — and they expect you to speak their language.
What are the findings? What is your diagnosis? STIR coronal images through the volar 1a and dorsal 1b aspect of the first metacarpophalangeal joint and STIR axial images at the metacarpal head 1c are provided. A portion of the inserting adductor pollicis tendon blue arrow is seen distal to this abnormality.