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.

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.

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.

Dislocations of the Metacarpophalangeal Joint of the Thumb

1997 ◽  
Vol 22 (4) ◽  
pp. 499-504 ◽  
Author(s):  
M. PATEL ◽  
J. DAVÉ
Keyword(s):  
Ulnar Collateral Ligament ◽  
Metacarpophalangeal Joint ◽  
Adductor Pollicis ◽  
Flexor Pollicis Longus ◽  
Collateral Ligament ◽  
Abductor Pollicis Brevis ◽  
Extensor Pollicis Longus ◽  
Palmar Plate ◽  
Cadaver Studies

We report 13 cases of thumb metacarpophalangeal dislocations, ten dorsal and three palmar. Eleven had complex dislocations requiring open reductions. With dorsal dislocations the palmar plate, the tendon of flexor pollicis longus and the “thenar trap” (adductor pollicis, flexor pollicis brevis and abductor pollicis brevis) were the main impediments to reduction. The dorsal capsule, extensor expansion and extensor pollicis longus and brevis prevented reduction with the uncommon palmar dislocations. Cadaver studies showed that dorsal dislocations are hyperextension and pronation injuries and palmar dislocations are hyperflexion and supination injuries. The unique “handlebar grip” injury which can cause either dorsal or palmar dislocations is also discussed. The palmar plate is the single most important stabilizer of the metacarpophalangeal joint and it is impossible to sustain a dislocation without tearing it. It is most likely to get entrapped within the joint in dorsal dislocations. Ulnar collateral ligament tears are more common with palmar dislocations.

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