Learning objectives
to determine the value of multimethod (RX,
US,
MRI) imaging in recognizing bone-ligament complex of the first metacarpophalangeal joint (MCP).
To describe images features of Stener lesion.
Background
Stener lesion is a complication of traumatism in the first MCP joint.
It occurs after a violent hyperabduction of the thumb associated with damage of the ulnar collateral ligament (UCL).
Rupture of the UCL may be total or partial and usually takes place at its distal point of insertion.
It may be accompanied by bone avulsion.
In total rupture of the UCL,
retraction can be mild or severe.
Severe retraction may also be associated with interposition of the adductor muscle aponeurosis,
which is called as...
Imaging findings OR Procedure details
radiographs show indirect signs such as a fracture- avulsion of the phalanx base,
but do not enable distinction injury ligament.
US detect the UCL retraction as a hypoechoic structure that determines the ligament rupture.
MRI demonstrates avulse bony fragments,
complete disruption of the UCL and particularly adductor muscle aponeurosis interposed between the ruptured ligament and its site of insertion at the base of the proximal phalanx.
Conclusion
multimethod images allow direct visualization and evaluation of entire UCL bone-ligament complex.
Rupture of the UCL of the first metacarpophalangeal joint is a frequent and potentially severe lesion because of their complications.
Stener lesion leads to permanent instability of MCP joint requiring plastic surgery of the ligament.
Personal Information
Agustín Marrero MD
Ezequiel Rombolá MD
Miembro Titular de la Sociedad Argentina de Radiología
CERTIFICACIÓN CCPM -ANM
ESR Membership
Contribution Philips International
Encargado del Servicio de RM Musculoesquelética de Investigaciones Médicas
Encargado del Servicio de RM de la Clínica del Sol
Diego Kallsten MD
Alejandro Beresnak MD
Director Médico Investigaciones Médicas
References
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Acute dislocation of the carpometacarpal joint of the thumb: an anatomic and cadaver study.
J Hand Surg; 19A: 93-98.
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Displacement of the ruptured ulnar collateral ligament of the metacarpophalangeal joint of the thumb.
J Bone Joint Surg.,
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1962.Scott J.
Erickson1
David H.
Hinke,
Scott J.
Erickson,
Lewis Chamoy,
Michael E.
Timins.
Ulnar collateral ligamento of the thumb; Mr findings in cadavers,
volunteers and patients with ligamentous injury (gamekepeer s thumb).
Presentation at the annual...