Presentation
Patient presented to ER with left thumb pain secondary to trauma
Patient Data
There is an intra-articular avulsion fracture of the base of the proximal phalanx of the left thumb.
Case Discussion
Background
The ulnar collateral ligament (UCL) of the thumb MCP joint is the most frequently injured collateral ligament in the hand. The mechanism of injury is caused by valgus stress across the thumb, often combined with hyperextenion.
Management
Most UCL sprains, partial tears and minimally displaced complete tears (as in our case) or avulsions, are managed by immobilization. Complete tears often required surgical exploration to locate and reattach the free edges of the torn ulnar collateral ligament.
Complications
The adductor tendon aponeurosis of the thumb can become interposed between the torn edges of the ulnar collateral ligament, a condition termed the Stener lesion. MRI can aid in identifying the position of the ligament. As the displaced ligament will not heal appropriately, Stener lesions are surgically corrected with anatomic reattachment of the displaced ligament.
Special thanks to Dr. Tamer El Holiby
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