A case series of Stener’s lesion of the first metacarpophalangeal joint

Kritika; Ashish Verma; Sanjay B. Shahu; Rajaram Sharma; Yogesh Kumar Sharma

doi:10.18203/issn.2455-4510.IntJResOrthop20230473

Authors

Kritika Department of Radio-diagnosis, Pacific Institute of medical sciences, Umarda, Udaipur, India
Ashish Verma Department of Orthopaedics, Pacific Institute of medical sciences, Umarda, Udaipur, India
Sanjay B. Shahu Department of Radio-diagnosis, Pacific Institute of medical sciences, Umarda, Udaipur, India
Rajaram Sharma Department of Radio-diagnosis, Pacific Institute of medical sciences, Umarda, Udaipur, India
Yogesh Kumar Sharma Department of Orthopaedics, Pacific Institute of medical sciences, Umarda, Udaipur, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20230473

Keywords:

UCL, Skier’s thumb, Stener’s lesion, Gamekeeper’s thumb

Abstract

Ulnar collateral ligament (UCL) injuries have a high prevalence however; these are usually being missed in the initial clinical evaluation. Depending on the chronicity of the injury there are two acronyms for UCL tear. One is the skier's thumb and the other is the gamekeeper's thumb. If the UCL of the first metacarpophalangeal joint (MCP joint) has a complete tear with entrapment of aponeurosis of adductor pollicis muscle between the MCP joint and torn ligament, is called a Stener’s lesion. This is a rare clinical entity that requires early surgical correction because of entrapment. The mechanism of injury is the coerced abduction of the thumb from the index finger, causing ligament tears or sprain with or without ensuing avulsion fracture. The incidence of Stener’s lesions associated with UCL rupture has been reported to be up to 52% per intra-operative finding. In Stener’s lesions, the UCL tears from the base of the proximal phalanx (PP) then retracts proximally and displaces superficial to the adductor pollicis. Here we are presenting four cases of Stener’s lesions, with the usefulness of magnetic resonance imaging (MRI) in diagnosing this entity, which can prevent possible long-term complications such as chronic pain, joint degeneration, and joint instability.

Metrics

Metrics Loading ...

References

Campbell CS. Gamekeeper's thumb. J Bone Joint Surg Br. 1955;37(1):148-9.

Doty JF, Rudd JN, Jemison M. Radial collateral ligament injury of the thumb with a Stener-like lesion. Orthopedics. 2010;33(12):925.

Coffey MJ, Stadnick ME, Thirkannad SM. Re: "Stener-like" lesion in the little finger. J Hand Surg Eur Vol. 2009;34(2):269-71.

Keyhani S, Mardani-Kivi M. Anatomical repair of Stener-like lesion of medial collateral ligament: a case series and technical note. Arch Bone Jt Surg. 2017;5(4):255-8.

Toffoli A, Chammas M. Stener-like lesions due to radial collateral ligament rupture in the metacarpophalangeal joints of two adjacent fingers: a case report and review of the literature. Hand Surg Rehabil. 2017;36(2):141-5.

Ishizuki M, Sugihara T, Wakabayashi Y, Shirasaka R, Aoyama H. Stener-like lesions of collateral ligament ruptures of the metacarpophalangeal joint of the finger. J Orthop Sci. 2009;14(2): 150-4.

Melville D, Jacobson JA, Haase S, Brandon C, Brigido MK, Fessell D. Ultrasound of displaced ulnar collateral ligament tears of the thumb: the Stener lesion revisited. Skelet Radiol. 2013;42(5):667-73.

Melville, David M. and Jacobson, Jon A. and Fessell, David P,Ultrasound of the Thumb Ulnar Collateral Ligament: Technique and Pathology. Am J Roentgenol. 2014;202(2);168.

Spaeth HJ, Abrams RA, Bock GW. Gamekeeper thumb: differentiation of nondisplaced and displaced tears of the ulnar collateral ligament with MR imaging. Work in progress. Radiology. 1993;188(2):553-6.

Louis DS, Buckwalter KA. Magnetic resonance imaging of the collateral ligaments of the thumb. J Hand Surg. 1989;14:739-41.