Locking of the metacarpophalangeal joint of the thumb with the radial collateral ligament rupture after stress radiography

The Stener-type lesion of the radial collateral ligament is rare. The insertion of the abductor pollicis brevis is believed to preclude its occurrence. The aim of this study was to determine whether this lesion can be induced mechanically. Four specimens were tested in neutral rotation and 20° of supination, in 45° and 30° of flexion, and in the neutral position. The angle of ulnar adduction to form a Stener-type lesion was measured. The lesion occurred only in 45° flexion in all specimens. A lesser angle of flexion decreased the rate of ligament displacement. In the neutral position no ligament displacement was found. A Stener-type lesion of the radial collateral ligament can occur in ulnar adduction and flexion of the metacarpophalangeal joint. Supination of the joint increases the likelihood of ligament displacement. As distal ruptures of the radial collateral ligament are uncommon, a high index of suspicion is required for diagnosis.

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Complete Tear of the Radial Collateral Ligament of the Third Metacarpophalangeal Joint

Orthopedics ◽

10.3928/0147-7447-20040701-13 ◽

2004 ◽

Vol 27 (7) ◽

pp. 733-736 ◽

Cited By ~ 3

Author(s):

Alan E Freeland ◽

E Rhett Hobgood

Keyword(s):

Metacarpophalangeal Joint ◽

Collateral Ligament ◽

Radial Collateral Ligament ◽

The Third ◽

Complete Tear

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Suture Anchor Repair of Chronic Radial Ligament Injuries of the Metacarpophalangeal Joint of the Thumb

Journal of Hand Surgery (European Volume) ◽

10.1016/s0266-7681(98)80196-4 ◽

1998 ◽

Vol 23 (2) ◽

pp. 271-274 ◽

Cited By ~ 34

Author(s):

T. P. McDERMOTT ◽

L. S. LEVIN

Keyword(s):

Suture Anchor ◽

Metacarpophalangeal Joint ◽

Ligament Injury ◽

Pinch Strength ◽

Collateral Ligament ◽

Chronic Instability ◽

Radial Collateral Ligament ◽

Suture Anchor Repair ◽

Thumb Metacarpophalangeal Joint

Five cases of chronic instability of the radial collateral ligament of the thumb metacarpophalangeal joint are presented. All patients were treated using the Mitek suture anchor to reattach the avulsed ligament to bone in its anatomical position. Tendon advancement or graft reinforcement was not used in conjunction with the repair. A stable thumb metacarpophalangeal joint was achieved in each case with no recurrent instability or pain found within 9 months of follow-up. Postoperatively, each patient exhibited a full return to activities of daily living within 2 to 3.5 months. Grip and pinch strength and range of motion were nearly the same as in the uninjured hand. We recommend the Mitek suture anchor as a simple and effective method of repairing the chronic radial collateral ligament injury. The importance of correct anatomical placement of the anchor is stressed, and guidelines for this are discussed.

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Radial Instability of the Metacarpophalangeal Joint of the Thumb

Journal of Hand Surgery (European Volume) ◽

10.1016/s0266-7681(05)80026-9 ◽

1995 ◽

Vol 20 (1) ◽

pp. 102-104 ◽

Cited By ~ 12

Author(s):

T. G. LOEBIG ◽

D. D. ANDERSON ◽

M. E. BARATZ ◽

J. E. IMBRIGLIA

Keyword(s):

Metacarpophalangeal Joint ◽

Volar Plate ◽

Human Cadaver ◽

Laboratory Setting ◽

Collateral Ligaments ◽

Collateral Ligament ◽

Radial Collateral Ligament ◽

Radial Side

Human cadaver thumbs were tested to evaluate stability of the radial side of the MP joint. The contributions of the dorsal capsule, radial collateral ligament, accessory collateral ligament, and volar plate were examined with the joint in 0° and 30° of flexion. At 0° flexion, the average joint angulation increased 4° following isolated radial collateral ligament transection and 6° following isolated accessory collateral ligament transection. Release of both the accessory and radial collateral ligaments produced marked instability with joint angulation of at least 46° The accessory collateral ligament helped to stabilize the extended MP joint. There were no significant contributions to stability from the dorsal capsule and volar plate when the collateral ligaments were intact. In the laboratory setting, radial-side instability of the MP joint of the thumb requires transection of both the proper and accessory radial collateral ligaments.

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