Presentation
Painful thumb.
Patient Data
Displaced avulsion fracture at the ulnar aspect of the distal first phalanx. Normal alignment.
Subluxation of the first metacarpophalangeal joint.
Complete tear of the ulnar collateral ligament at the first metacarpophalangeal joint with fibers retracted proximally lying superficial to the level of the abductor pollicis aponeurosis/tendon, compatible with a Steiner lesion. The small avulsion fracture seen on the prior x-ray is not confidently identified.
Small proximal partial tear of the radial collateral ligament. Marrow edema at the first metacarpal head, predominantly on the volar aspect with a small further focus of marrow edema within the ulnar aspect of the first proximal phalanx base at the ulnar collateral ligament insertion. Additionally at the first metacarpophalangeal joint, there is a small joint effusion, capsular sprain, and mild edema of the sesamoids.
Flexor and extensor tendons are intact without tenosynovitis.
Case Discussion
This is an example of complete rupture of the first metacarpophalangeal joint ulnar collateral ligament with a Stener lesion.
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