History of fall on ground while walking - 9 days. C/o thumb base pain.
Radiograph of thumb - No fracture or dislocation ( Not uploaded, No copyright )
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Symptomatic side shows absence of ulnar collateral ligament in normal location. There is a hypoechoic pseudomass formation proximal to joint line; abutting metacarpal bone. There is no associated bone flake avulsion or defect in phalanx base. There was no sesamoid fracture at thumb. Flexure and extensor tendon were normal.
Asymptomatic side shows normal position and echopattern of ulnar collateral ligament.
Female presented with thumb trauma due to fall on ground. Ultrasound shows absent ulnar collateral ligament along with formation of a hypoechoic pseudomass abutting metacarpal bones. When ruptured ligament is displaced over adductor pollicis aponeurosis; there is a pseudomass formation proximal to joint line and abutting metacarpal bone. It is called as Stener lesion. No surgical follow up is available.
Ulnar collateral ligament of thumb shows three types of injury.
- Avulsion of distal end of ligament along with a bone flake. There is easily seen on radiographs.
- Tear of collateral ligament ( usually distal end ) with ligament in situ - deep to adductor pollicis apneurosis. There is no pseudomass formation in this case.
- Ruptured and displaced ligement over aponeurosis forming a pseudomass. It is known as Stener lesion. This requires surgical treament.
- Ultrasound of the Musculoskeletal System S. Bianchi, C. Martinoli. First Indian Reprint 2007.