OCAD MSK

History

23-year-old man with history of ulnar deviation trauma of the thumb and persistent metacarpophalangeal joint pain.

Figure 1 for case Complete proximal tear of the radial collateral ligament of the MPJ of the thumb — Figure 1

Figure 2 for case Complete proximal tear of the radial collateral ligament of the MPJ of the thumb — Figure 2

Figure 3 for case Complete proximal tear of the radial collateral ligament of the MPJ of the thumb — Figure 3

Figure 4 for case Complete proximal tear of the radial collateral ligament of the MPJ of the thumb — Figure 4

Discussion

Radial collateral ligament injuries caused by an ulnar-directed force. Far less frequently than UCL injuries (ratio of 1:9).
The location of RCL injuries is more variable than UCL ones. The lesion was proximal in 55% of patients, distal in 29%, and midsubstance in 16%.
The abductor pollicis aponeurosis extends more proximally and dorsally than the adductor aponeurosis, covering completely the RCL, and avoiding the occurrence of the equivalent of a Stener lesion.
Complete tears are managed surgically (transosseous suture or suture anchor), because conservative treatment leads to chronic instability and arthrosis. Reference article.

Diagnosis

Complete proximal tear of the radial collateral ligament of the MPJ of the thumb

Luis Cerezal, MD PhD

Courtesy

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