Assessment of Rotational Instability with Disruption of the Accessory Collateral Ligament of the Thumb MCP Joint: A Biomechanical Study

Fraser, Bonnie J.; Veitch, John M.; Firoozbakhsh, Keikhosrow

doi:10.1007/s11552-008-9088-0

Cited by 12 publications

(8 citation statements)

References 23 publications

(23 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The order of sectioning the tissues, pUCL, aUCL, and then the aponeurosis, reproduced the sequence of injury in traumatic events. 10,16) Similar to the finding of Adler et al, we were unable to create a Stener lesion after complete sectioning of the UCL at 0°and 30° of flexion with no rotation. 16) We also did not create a Stener lesion with supination or pronation with intact overlying fascia.…”

Section: Discussionsupporting

confidence: 83%

“…8) Acute injuries are the result of a sudden, significant radial force causing abduction of the thumb. [9][10][11] The results of stress testing of the thumb MCP joint help to determine whether treatment will be non-operative with immobilization or with surgical reconstruction or repair. Fluoroscopy, MRI and ultrasound are increasingly being used and evaluated as diagnostic tools.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Can Physical Examination Create a Stener Lesion?

Lankachandra

Eggers

Bogener

et al. 2017

J Hand Surg Asian-Pac Vol

View full text Add to dashboard Cite

Background: The purpose of this study is to determine whether a Stener lesion can be created while testing stability of the ulnar collateral ligament (UCL) of the thumb. Testing was performed in a manner that reproduced clinical examination. Methods: Six fresh frozen hand and forearm specimens underwent sequential sectioning of the accessory UCL, the proper UCL, and the ulnar sagittal band. Measurements of radial deviation of the metacarpophalangeal (MCP) joint were taken with the thumb in neutral rotation, pronation and supination, both with 0 degrees and with 30 degrees of flexion of the MCP joint. Visual examination was performed to assess the presence of a Stener lesion. Results: No Stener lesion was created in any position as long as the fascial origin of the ulnar sagittal band at the adductor pollicis longus remained intact. After creating a defect in the ulnar sagittal band, a Stener lesion was created in two specimens, but only when the thumb was flexed and supinated. Pronation provided more stability, and supination provided less stability, with one or both components cut, especially when testing at 30° of flexion. Compared to both components cut without flexion or rotation, there was a statistically significant difference in angulation with the 30 degrees of MCP joint flexion in both neutral rotation in supination. Conclusions: Performing a physical examination to assess the amount of instability of an ulnar collateral ligament injury did not create a Stener lesion if the exam was performed in a controlled, gentle manner with the thumb held without rotation. If the thumb is held in neutral rotation during the exam, an iatrogenic Stener lesion should not be created.

show abstract

Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Can Physical Examination Create a Stener Lesion?

Lankachandra

Eggers

Bogener

et al. 2017

J Hand Surg Asian-Pac Vol

View full text Add to dashboard Cite

show abstract

“…The accessory collateral ligament lies palmar to the proper ligament and is in continuity with it and the volar plate [16,26]. The role of the accessory collateral ligament in thumb stability has recently been proven [9].…”

Section: Anatomymentioning

confidence: 99%

Injury to the Ulnar Collateral Ligament of the Thumb

Tsiouri

Hayton

Baratz

2008

Hand (New York, N,Y.)

View full text Add to dashboard Cite

show abstract

“…The ACL lies palmar to the UCL and attaches at the palmar plate and the ulnar sesamoid (Stener,1962; Fraser et al,2008; Anderson,2010). The UCLC is covered by the aponeurosis of the adductor muscle (Stener,1962).…”

Section: Introductionmentioning

confidence: 99%

Can clinical examination cause a Stener lesion in patients with skier's thumb?: A cadaveric study

et al. 2011

View full text Add to dashboard Cite

Approximately one-third of all injuries of the upper limb and 7% of all injuries in skiing affect the ulnar collateral ligaments of the thumb metacarpophalangeal joint (skier's thumb). In some patients the collateral ligaments are displaced proximally over the adductor aponeurosis, resulting in a so-called Stener lesion. In these cases surgical treatment is indicated. We hypothesized that a Stener lesion could be provoked by clinical stability testing in patients with a skiers thumb and performed a cadaveric study on 10 Thiel fixated cadaver hands. For clinical stability testing, the thumb was manually deviated in radial direction in both 308 flexion and extension of the MP-joint. It was performed with maximum strength by two hand surgeons after sequential detachment of the ulnar collateral ligaments. After every sequence, it was assessed if the clinical stability testing had caused a Stener lesion. All of the 10 cadavers showed identical results while testing the clinical stability. A decreased stability was only found after cutting both parts of the ulnar collateral ligaments. A Stener lesion could not be provoked in any of the cadavers at any time by clinical stability testing. Summarizing our findings we conclude that a proper performed clinical stability testing of the thumb MP joint is a safe maneuver, which does not lead to a Stener lesion in patients with skier's thumb. Clin. Anat. 25:762-766, 2012. V V C 2011 Wiley Periodicals, Inc.

show abstract

Assessment of Rotational Instability with Disruption of the Accessory Collateral Ligament of the Thumb MCP Joint: A Biomechanical Study

Cited by 12 publications

References 23 publications

Can Physical Examination Create a Stener Lesion?

Can Physical Examination Create a Stener Lesion?

Injury to the Ulnar Collateral Ligament of the Thumb

Can clinical examination cause a Stener lesion in patients with skier's thumb?: A cadaveric study

Contact Info

Product

Resources

About