The Two-Level Ulnar Collateral Ligament Injury of the Metacarpophalangeal Joint of the Thumb

2003 ◽  
Vol 28 (1) ◽  
pp. 92-93 ◽  
Author(s):  
H. GIELE ◽  
J. MARTIN
Keyword(s):  
Ulnar Collateral Ligament ◽  
Operative Management ◽  
Metacarpophalangeal Joint ◽  
Ligament Injury ◽  
Collateral Ligament ◽  
Fracture Fragment ◽  
Avulsion Fractures ◽  
Stener Lesion ◽  
Careful Clinical Examination ◽  
Displaced Fracture

Ulnar collateral ligament injuries of the thumb may present as avulsion fractures of the bone or as ligamentous tears. Displaced fracture fragments or Stener lesions demand operative management. Occasionally, both fracture and ligamentous tears may occur simultaneously, and the management of the ligamentous aspect may be overlooked in cases with undisplaced fractures leading to failure of non-operative treatment. It is important in cases with a relatively undisplaced fracture fragment to exclude a simultaneous ligamentous tear and Stener lesion by careful clinical examination and by examining the radiographs for telltale displaced flecks of bone.

The ‘‘Two Fleck Sign’’ for an Occult Stener Lesion

2008 ◽  
Vol 33 (2) ◽  
pp. 208-211 ◽  
Author(s):  
SUNIL THIRKANNAD ◽  
THOMAS W. WOLFF
Keyword(s):  
Retrospective Review ◽  
Ulnar Collateral Ligament ◽  
Metacarpophalangeal Joint ◽  
Adductor Pollicis ◽  
Collateral Ligament ◽  
Fracture Fragment ◽  
Adductor Pollicis Muscle ◽  
X Ray ◽  
Stener Lesion

We report a case of distal pull-off of the ulnar collateral ligament of the metacarpophalangeal joint of the thumb with two fracture fragments. The more obvious fracture fragment, seen on plain X-ray to be lying adjacent to the expected location of the attachment of the ulnar collateral ligament of the metacarpophalangeal joint of the thumb, was, in fact, unassociated with it and was part of the attachment of the adductor pollicis muscle. A second smaller fleck of bone which was attached to the displaced collateral ligament was only observed on plain X-ray on retrospective review. This second fleck of bone identified that this was a Stener lesion, requiring surgical reattachment of the ligament. Similar cases in the literature are reviewed and the use of MRI in detecting these lesions is discussed.

Locked Metacarpophalangeal Joint of the Little Finger in Extension Position due to the Incarceration of a Chronic Fracture Fragment: A Case Report

2018 ◽  
Vol 23 (04) ◽  
pp. 601-604 ◽  
Author(s):  
Shunsuke Asakawa ◽  
Takeshi Ogawa
Keyword(s):  
Case Report ◽  
Open Reduction ◽  
Ulnar Collateral Ligament ◽  
Metacarpophalangeal Joint ◽  
Volar Plate ◽  
Collateral Ligament ◽  
Fracture Fragment ◽  
Osteochondral Fracture ◽  
Unique Condition ◽  
Little Finger

We managed a case of locked metacarpophalangeal joint of the little finger in the extension position. Incarceration of a chronic osteochondral fracture fragment led to this unique condition. The fracture fragment partially adhered to the volar plate and ulnar collateral ligament on the joint side, which is supposed to have resulted in manually irreducible locking of the joint. We performed open reduction and achieved release of the locked joint by excising the fracture fragment.

scholarly journals The Stener Lesion: Historical Perspective and Evolution of Diagnostic Criteria

Hand ◽  
2016 ◽  
Vol 12 (3) ◽  
pp. 283-289 ◽  
Author(s):  
Meghan E. Lark ◽  
Brianna L. Maroukis ◽  
Kevin C. Chung
Keyword(s):  
Ulnar Collateral Ligament ◽  
Metacarpophalangeal Joint ◽  
Extensive Literature ◽  
Collateral Ligament ◽  
Treatment Algorithms ◽  
Ligament Rupture ◽  
Stener Lesion ◽  
Extensive Literature Search ◽  
Magnetic Resonance Imaging Mri ◽  
Us Technology

Background: In 1962, Bertil Stener first described the anatomy and treatment of the displaced ulnar collateral ligament of the metacarpophalangeal joint, later called the Stener lesion. Since Stener’s publication, treatment algorithms for ulnar collateral ligament rupture have aided in preoperative diagnosis, yet the best diagnostic method to assess ligament displacement remains largely undefined. Methods: An extensive literature search was performed to explore the treatment evolution of the Stener lesion and explore how technical development has influenced Stener lesion diagnosis. We also sought to illuminate the life and work of Bertil Stener. Results: Studies evaluating the use of magnetic resonance imaging (MRI) and ultrasound (US) technology have suggested that these modalities have improved Stener lesion diagnosis. Conclusion: Despite the utility of developing MRI and US technology, consensus for one superior diagnostic tool for Stener lesions does not currently exist.

SIMULTANEOUS METACARPOPHALANGEAL JOINT ULNAR COLLATERAL LIGAMENT INJURY AND CARPOMETACARPAL DISLOCATION OF THE THUMB IN A FOOTBALL PLAYER: A CASE REPORT

Hand Surgery ◽  
2009 ◽  
Vol 14 (01) ◽  
pp. 23-24 ◽  
Author(s):  
Amit Bhargava ◽  
Andrew G. Jennings
Keyword(s):  
Unusual Case ◽  
Correct Diagnosis ◽  
Ulnar Collateral Ligament ◽  
Football Player ◽  
Metacarpophalangeal Joint ◽  
Ligament Injury ◽  
Collateral Ligament ◽  
Ulnar Collateral Ligament Injury ◽  
High Index Of Suspicion

An unusual case of ulnar collateral ligament avulsion in association with carpometacarpal dislocation of thumb is described. Symptoms and deformity caused by dislocation can mask the presence of injuries such as damage to the ulnar collateral ligament of thumb. This may lead to long term disability. A high index of suspicion and good clinical examination allows correct diagnosis and management of these uncommon injuries leading to a good clinical outcome.

Can Physical Examination Create a Stener Lesion?

2017 ◽  
Vol 22 (03) ◽  
pp. 350-354
Author(s):  
Manesha Lankachandra ◽  
John P. Eggers ◽  
James W. Bogener ◽  
Richard L. Hutchison
Keyword(s):  
Physical Examination ◽  
Ulnar Collateral Ligament ◽  
Ligament Injury ◽  
Collateral Ligament ◽  
Visual Examination ◽  
Stener Lesion ◽  
Significant Difference ◽  
Fresh Frozen ◽  
Ulnar Collateral Ligament Injury ◽  
Joint Flexion

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.

Avulsion Fracture of the Metacarpophalangeal Joint of the Finger

1997 ◽  
Vol 22 (5) ◽  
pp. 667-671 ◽  
Author(s):  
M. SAKUMA ◽  
R. NAKAMURA ◽  
G. INOUE ◽  
E. HORII
Keyword(s):  
Avulsion Fracture ◽  
Functional Result ◽  
Articular Surface ◽  
Metacarpophalangeal Joint ◽  
Ligament Injury ◽  
Collateral Ligament ◽  
Avulsion Fractures ◽  
Operative Findings ◽  
Type Of Fracture ◽  
Treatment Surgery

Six patients with avulsion fractures of the metacarpophalangeal joints of the fingers are reported. Operation was performed in all cases. Judging from the operative findings, the radiological assessment of fragment shape is helpful in treatment. Surgery is recommended when the fragment is triangular or rectangular in shape because the fracture involves the articular surface. Conservative treatment is effective if the fragment is round because the articular surface of the joint is not involved in this type of fracture. The avulsed fragment often overlaps the metacarpal head and a collateral ligament injury is likely to be misdiagnosed. It is important to suspect this injury and assess the shape of the whole fragment for a good functional result.

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