Stener lesion

Stener lesions are seen in the context of a torn ulnar collateral ligament of the thumb's metacarpophalangeal joint (gamekeeper's thumb). 

Pathology

Normally, the ulnar collateral ligament lies deep to the adductor pollicis tendon. A Stener lesion is characterised by slippage of the torn end of the ulnar collateral ligament superficial to the adductor aponeurosis/adductor pollicis muscle such that now there is interposition of the adductor pollicis muscle between the ulnar collateral ligament and the MCP joint. This prevents healing and is an indication for surgical repair.

Radiographic features

  • evaluation for a Stener lesion requires MRI or high frequency ultrasound
    • these studies are usually performed after a diagnosis of gamekeeper's thumb has been made on a hand radiograph
    • a Stener lesion is proximal retraction of the ligament fibers which looks like a small mass displaced superficial to the adductor aponeurosis; this gives the yo-yo on a string appearance both on ultrasound and MRI images 5
  • abduction stress views are no longer recommended as this itself can cause a Stener lesion in an otherwise asymptomatic patient

History and etymology

It was first described by B Stener in 1962 3-4.

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Article Information:

rID: 7614
System: Musculoskeletal
Section: Signs
Tags: thumb, lesion
Synonyms or Alternate Spellings:
  • Stener's lesion
  • Stener lesions
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    Stener lesion

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    Torn and retracte...
    Case 1
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    Case 2: with yo-yo sign
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    Case 3
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