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The Stener lesion revisited: a case report
1Mid Atlantic Permanente Medical Group, Springfield, VA, USA.
The Journal of Hand Surgery
|October 8, 1998
Summary
A Stener lesion, a thumb ligament injury, can cause instability if the ligament is displaced. Even without bone fragment displacement, physical exams are crucial for assessing thumb joint stability.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Sports Medicine
Background:
- The ulnar collateral ligament (UCL) of the thumb's metacarpophalangeal (MCP) joint is vital for thumb stability.
- A Stener lesion occurs when the UCL ruptures and proximally displaces, often associated with a fracture fragment.
- Untreated proximal displacement can lead to chronic MCP joint instability.
Observation:
- Rupture of the UCL without proximal displacement typically results in a full recovery.
- Associated fractures are often used to infer the UCL's position.
- Two cases are presented where UCL displacement occurred without displacement of an associated bony fragment.
Findings:
- UCL displacement can occur independently of bony fragment displacement.
- Radiographic evidence of a fracture does not always indicate UCL displacement.
- Physical examination is essential for accurate diagnosis of UCL injuries.
Implications:
- Relying solely on fracture patterns may lead to underdiagnosis of unstable UCL injuries.
- Clinical assessment is paramount for determining the stability of thumb MCP joint injuries.
- Accurate diagnosis of Stener lesions ensures appropriate treatment and prevents chronic instability.