The Journal of Bone and Joint Surgery, Vol 68, Issue 9 1320-1326, Copyright © 1986 by Journal of Bone and Joint Surgery, Inc
Rupture and displacement of the ulnar collateral ligament of the metacarpophalangeal joint of the thumb. Preoperative diagnosis
DS Louis, JJ Huebner and FM Hankin
The evaluation and treatment of injuries of the ulnar collateral ligament
of the metacarpophalangeal joint of the thumb remain controversial. In a
retrospective study that was done to assess our ability to determine
whether displacement of the ligament (a Stener lesion) was present, we
reviewed our accumulated experience with patients who had an injury of this
ligament who were treated surgically between 1972 and 1984. Since our
method of evaluation changed in 1977, we compared the preoperative and
operative diagnoses in the twenty patients who were treated surgically from
1972 through 1976 with those in the twenty patients who were so treated
from 1977 through 1984. Considering all forty patients who were treated
operatively, sixteen (40 per cent) had a typical Stener lesion, and in two
others (5 per cent) the ulnar collateral ligament was rolled up on itself
and lying beneath the adductor aponeurosis. From 1972 through 1976,
stability was tested with the metacarpophalangeal joint in complete
extension or in varying amounts of flexion. Of the twenty thumbs that were
evaluated by this technique and were treated surgically, 20 per cent had a
Stener lesion. From 1977 through 1984, stability was tested with the joint
in full flexion because of the findings in anatomical studies that were
completed in 1977; the incidence of a Stener lesion in the twenty thumbs
that were treated by repair or reattachment of the ligament during this
time was 70 per cent.(ABSTRACT TRUNCATED AT 250 WORDS)