Stener lesion

Case contributed by Chris Newman
Diagnosis almost certain

Presentation

Fall on left hand. Deformity at the first metacarpophalangeal joint

Patient Data

Age: 80 years
Gender: Male
x-ray
Lateral
Oblique
Frontal
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Info
  • laterally dislocated first metacarpophalangeal joint. No visible acute fracture
ultrasound
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Info
  • laxity and osseous irregularity of the first metacarpophalangeal joint
  • complete tear of the first MCPJ ulnar collateral ligament with retraction of the proximal fibres
  • the adductor pollicis aponeurosis inserts deep to the proximal aspect of the UCL in keeping with a Stener lesion (see arrowed image)

Case Discussion

The patient went on to have an ulnar collateral ligament repair with an intra-osseous anchor being placed.  The interposition of the adductor pollicis aponeurosis between the UCL and the MCPJ prevents healing.

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