Thumb metacarpophalangeal ulnar collateral ligament

Thumb metacarpophalangeal ulnar collateral ligament

Injury to the thumb metacarpal ulnar collateral ligament is a unique injury often termed ‘gamekeeper’s thumb’ or ‘skier’s thumb’. Owing to the unique anatomical arrangement of adductor pollicis, if the ligament undergoes complete rupture the aponeurosis may become interposed, inhibiting - - - - t the

(ai) (aii) (b) (c) (d) Figure 32.21 Scaphoid fracture. (a) Anteroposterior (i) and lateral (ii) views in which the injury is dif /f_i cult to see; (b, c) oblique views with the fracture line highlighted; (d) in this case of a young patient, the fracture was treated with early /f_i xation.

Cap Rad Lun ligament-to-bone healing. A rupture of the ulnar collateral ligament should be suspected when an ulna-directed force is directed across the metacarpophalangeal (MCP) joint. A tender swelling on the ulnar side of the MCP joint may signify the Stener lesion. Increased laxity may be clinically evident; if there is uncertainty , stress radiographs can demonstrate the degree of injury . Complete ruptures with a Stener lesion (interposed aponeurosis) require open reduction of the liga ment to restore bone contact, with a suture anchor repair of the associated ulnar collateral ligament.

(b) Figure 32.22 Perilunate dislocation. (a) A plain lateral radiograph of the wrist; (b) the outline of the perilunate dislocation is highlighted. Cap, capitate; Lun, lunate; Rad, radius.