Displacement of the Ruptured Ulnar Collateral Ligament of the Metacarpo-Phalangeal Joint of the Thumb

Stener, Bertil

doi:10.1302/0301-620x.44b4.869

Cited by 389 publications

(175 citation statements)

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“…The appearance of this lesion was similar to that of the displaced lesion of the ulnar collateral ligament of the first MCP joint over the adductor aponeurosis, as described by Stener [8]. As with the Stener lesion, direct healing of the displaced MCL fibers to the bony insertion site of the tibia was presumed impossible, thereby possibly leading to persistent valgus laxity and residual functional instability.…”

Section: Discussionsupporting

confidence: 69%

“…Disruption of the distal insertion site of the ulnar collateral ligament of the first metacarpophalangeal (MCP) joint and displacement over the adductor aponeurosis were described by Stener [8] in 1962. Some surgeons believe the Stener lesion, also known as a skier's or gamekeeper's thumb, warrants surgery to restore the laxity and preserve the functional stability of the first MCP joint [3,8].…”

Section: Introductionmentioning

confidence: 99%

“…Some surgeons believe the Stener lesion, also known as a skier's or gamekeeper's thumb, warrants surgery to restore the laxity and preserve the functional stability of the first MCP joint [3,8].…”

Section: Introductionmentioning

confidence: 99%

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Case Reports: A Stener-like Lesion of the Medial Collateral Ligament of the Knee

Corten

Hoser²,

Fink³

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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When the superficial fibers of the medial collateral ligament of the knee are torn without tearing of the deep fibers, the anterior superficial fibers may displace over the pes anserinus tendons, so that healing back to the tibial insertion site may be jeopardized. As only the anterior superficial and not the posterior superficial or deep fibers are disrupted, the knee will not have increased valgus laxity in extension whereas there is not a firm end point in 30°flexion. The clinical findings could be confused with those of a Grade 2 medial collateral ligament sprain that generally is not associated with displacement of the anterior fibers over the pes anserinus tendons. We describe the diagnostic findings confirmed with surgical exploration of two Stener-like disruptions of the medial collateral ligament of the knee.

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Section: Discussionsupporting

confidence: 69%

Section: Introductionmentioning

confidence: 99%

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Case Reports: A Stener-like Lesion of the Medial Collateral Ligament of the Knee

Corten

Hoser²,

Fink³

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…Thus, the tom ligament can become trapped by the aponeurosis and folded over to point proximally, when the abduction force is released (Stener 1962). Closed treatment is adequate for nondisplaced ruptures (Newland 1992, Spaeth et at.…”

Section: Discussionmentioning

confidence: 99%

Ulnar collateral ligament injuries of the thumb: Dislocation caused by stress radiography in 2 cases

Noszian

Dinkhauser

Straub

et al. 1995

Acta Orthopaedica Scandinavica

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“…Partial injuries of the proper ulnar collateral ligament and complete injuries in situ may be treated nonoperatively with immobilization [8]. Complete disruptions, especially those involving the Stener lesion [11], or displaced bony avulsions, usually warrant acute surgical repair. Operative techniques include but are not limited to transosseous suture repair, midsubstance repair, and more recently, suture anchor repair [8].…”

Section: Introductionmentioning

confidence: 99%

Ulnar Collateral Ligament Strain of the Thumb Metacarpophalangeal Joint: Biomechanical Comparison of Two Postoperative Immobilization Techniques

Lien

Brunfeldt

Julka

et al. 2015

Hand (New York, N,Y.)

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Background The aim of this study was to compare postopera t i v e i m m o b i l i z a t i o n t e c h n i q u e s o f t h e t h u m b metacarpophalangeal (MP) ulnar collateral ligament (UCL) in a cadaver model of a noncompliant patient. Methods A cadaveric model with fresh-frozen forearms was used to simulate pinch under two immobilization conditions: (1) forearm-based thumb spica splint alone and (2) forearmbased thumb spica splint with supplemental transarticular MP Kirschner wire fixation. Pinch was simulated by thumb valgus loading and flexor pollicis longus (FPL) loading. Ulnar collateral ligament displacements were measured and strain values calculated. Statistical analysis was performed using a repeated measures analysis of variance model. Results With valgus thumb loading, we noted a significantly lower UCL strain in the splint and pin group compared to splint immobilization alone. Increased load was associated with a statistically significant increase in UCL strain within each immobilization condition. FPL loading resulted in negative displacement, or paradoxical shortening, of the UCL in both immobilization groups. Conclusions While immobilized, valgus thumb force, as opposed to MP flexion, is a likely contributor to UCL strain during simulated pinch representing noncompliance during the postoperative period. Supplemental thumb MP pin fixation more effectively protects the UCL from valgus strain. UCL shortening with FPL loading likely represents paradoxical MP extension due to flexion of the distal phalanx against the distal splint, suggesting attempted thumb flexion with splint immobilization alone does not jeopardize UCL repair. Clinical Relevance This study provides a foundation to aid clinical decision-making after UCL repair. It reinforces the practice of surgeons who routinely pin their MP joints, but also brings to attention that the use of temporary MP pin fixation may be considered in difficult cases, such as those with potential noncompliance or tenuous repair.

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Displacement of the Ruptured Ulnar Collateral Ligament of the Metacarpo-Phalangeal Joint of the Thumb

Cited by 389 publications

References 0 publications

Case Reports: A Stener-like Lesion of the Medial Collateral Ligament of the Knee

Case Reports: A Stener-like Lesion of the Medial Collateral Ligament of the Knee

Ulnar collateral ligament injuries of the thumb: Dislocation caused by stress radiography in 2 cases

Ulnar Collateral Ligament Strain of the Thumb Metacarpophalangeal Joint: Biomechanical Comparison of Two Postoperative Immobilization Techniques

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