Chronic Thumb Metacarpophalangeal Joint Ulnar Collateral Ligament Insufficiency

Rhee, Peter C.

doi:10.1016/j.jhsa.2011.06.004

Cited by 11 publications

(4 citation statements)

References 16 publications

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“…25 In contemporary times, chronic UCL tears due to repetitive stress in sports is relatively uncommon. 26 Tears of the ligament range from sprain to partial or complete tear. The complete tears can be further divided into displaced or nondisplaced injuries.…”

Section: Ulnar Collateral Ligament Injuries Of the Mcp Jointmentioning

confidence: 99%

Thumb Injuries and Instabilities. Part 2: Spectrum of Lesions

Blum

Holsbeeck

Bianchi

2021

Semin Musculoskelet Radiol

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The motor function of the thumb and its alignment with regard to the hand make it particularly vulnerable to trauma. Pathology encountered in this joint is varied, and imaging techniques play a crucial role in the diagnosis and characterization of injury. Despite advances in imaging technology, acute thumb injuries remain a challenge for radiologists. Currently, standard radiography and ultrasonography are frequently used first-line imaging techniques. Computed tomography is most often indicated for complex fractures and dislocations. Magnetic resonance imaging may be used to optimally characterize soft tissues and bone marrow. In this article, we cover the most common traumatic injuries: fractures, dislocations, collateral ligament injuries of the metacarpophalangeal joint, as well as soft tissue lesions.

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Section: Ulnar Collateral Ligament Injuries Of the Mcp Jointmentioning

confidence: 99%

Thumb Injuries and Instabilities. Part 2: Spectrum of Lesions

Blum

Holsbeeck

Bianchi

2021

Semin Musculoskelet Radiol

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“…4,5 Chronic injury resulting in ligament insufficiency, or Gamekeeper's thumb, may also develop as a result of repetitive trauma. 6,7 The thumb UCL is the primary static stabilizer against valgus stress and is composed of 2 components: the proper collateral ligament and the accessory collateral ligament. 8 These separate ligamentous bundles have been shown to have a different functionality in resisting valgus stress at various degrees of thumb flexion, with the proper collateral ligament contributing more in flexion and the accessory collateral ligament contributing more in extension.…”

Section: Introductionmentioning

confidence: 99%

“…4,5 Chronic injury resulting in ligament insufficiency, or Gamekeeper’s thumb, may also develop as a result of repetitive trauma. 6,7…”

Section: Introductionmentioning

confidence: 99%

Biomechanical Analysis of Thumb Ulnar Collateral Ligament Tear Kinematics

Lin

Patel

Itami

et al. 2019

Hand (New York, N,Y.)

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Background: Thumb ulnar collateral ligament (UCL) injuries are common, but the kinematics of these injuries have not been comprehensively described, especially regarding kinematic changes with progressive UCL injury. Methods: Eleven cadaveric thumbs underwent kinematic testing under 4 conditions: intact, partial tear (50%) of the proper UCL, full tear of the proper UCL, and complete tear of both the proper and accessory UCL. Kinematic testing parameters included varus/valgus stress, pronation/supination, and volar/dorsal translation at −10 degree, 0 degree, 15 degree, and 30 degree of metacarpophalangeal flexion. Results: Partial tear of the proper UCL did not result in significant increases in laxity in any direction compared with intact ( P ≥ .132). Full tear of the proper UCL resulted in a significant increase in valgus angulation (18.8° ± 1.7° vs 11.5° ± 1.5°; P = .024) and pronation (15.4° ± 2.5° vs 12.6° ± 2.3°; P = .034) at 30 degree of flexion relative to intact. Complete tear of both the proper and accessory collateral ligaments resulted in increased valgus angulation at all degrees of flexion ( P < .001). Complete tear also resulted in a significant volar translation at 0 degree, 15 degree, and 30 degree of flexion ( P ≤ .016). Conclusion: Partial tear of the proper UCL does not significantly affect the stability of the joint, but full tear of the proper UCL increases valgus instability at 30 degree of flexion. Complete tear of the UCL is necessary for increased varus/valgus instability at all degrees of flexion and results in significant increases in pronation/supination and volar translation.

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“…For acute unstable injuries, an acute repair is advocated [16], with bone anchors giving excellent results [3, 17]. At more than 3 weeks between injury and surgery, “chronic” cases require reconstruction rather than repair [13, 15], with a tendon graft giving good results [5]. Optimal operative planning prior to surgical treatment is more difficult in the minority of patients whose history and examination are inconclusive in relation to the chronicity of the injury.…”

Section: Introductionmentioning

confidence: 99%