Wk 3, Case 5 - Review

Patient History
41-year-old male with left thumb pain.

Findings

LIGAMENTS: The proper ulnar collateral ligament (UCL) of the left 1st metacarpophalangeal (MCP) joint are torn and detached from their volar attachment near the ulnar tubercle at the 1st phalangeal base distally, thickened and retracted to their origin at the dorsal aspect of the 1st metacarpal head. Interposed within these retracted ligaments, an inflamed adductor aponeurosis is appreciated.

Findings compatible with “yoyo on a string” or “lollipop sign” of a Stener lesion.

OSSEOUS: No macrofracture is identified.

TENDONS: The extensor pollicis longus, extensor pollicis brevis and flexor pollicis longus are intact.

GENERAL: Diffuse soft tissue swelling throughout the thumb, the adductor pollicis muscle and thenar eminence.

Impressions
1.High-grade tear, retracted rupture of the proper ulnar collateral ligaments of the left thumb at their volar attachments in the ulnar tubercle of the 1st phalanx with proximal retraction and an interposed adductor aponeurosis in keeping with a Stener lesion.