Presentation
Fall on left hand. Deformity at the first metacarpophalangeal joint
Patient Data
Age: 80 years
Gender: Male
From the case:
Stener lesion
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/123488/annotated_viewer_json?iframe=true\u0026lang=us"}
- laterally dislocated first metacarpophalangeal joint. No visible acute fracture
From the case:
Stener lesion
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/123629/annotated_viewer_json?iframe=true\u0026lang=us"}
- laxity and osseous irregularity of the first metacarpophalangeal joint
- complete tear of the first MCPJ ulnar collateral ligament with retraction of the proximal fibers
- 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.