Thumb Ulnar Collateral Ligament injuries can occur as a result of a sudden force or less commonly, due to chronic overstretching of the ligament.
The clinical signs of this debilitating condition are pain, swelling, and instability of the thumb which causes problems with the functionality.
This is why a thorough clinical examination is important, and highly recommended in order to fully establish the degree of instability. We have to test to see if there is an endpoint.
Sometimes it can be difficult to properly assess how much pain the patient is in as the patient may tense up other associated muscles in response, which won’t give you a true indication as to the degree of instability.
If the patient won’t let you fully examine them, or if there is a significant degree of instability, then an ultrasound is really important. Sometimes x-rays are sufficient, however, it is often useful to get an ultrasound to exclude a stener lesion.
A stener lesion occurs when the displaced or torn UCL ligament flicks back and then sits superficially on the aponeurosis of the adductor pollicus muscle, so it physically can’t reattach to the MCP joint. Unfortunately, stener lesions and complete Ulnar Collateral Ligament ruptures require surgery.
When surgery is performed, a mitek anchor with a K-wire fixation is used whilst the healing process occurs. With surgery, if the ligament tear is picked up early, the ligament may be repaired with sutures, however if it is a later presentation, then the ligament may need to be reconstructed.
A Ulnar Collateral Ligament injury is really important to diagnose and treat correctly. Conservative management is successful if the ligament is partially torn or if there is a small avulsion however, stener lesions and complete tears will require surgery.
If you would like to have your injured thumb examined by one of our fully qualified therapists, please call us at Melbourne Hand Therapy today (03) 9899 8490 or leave an enquiry and we will get back to you as soon as possible.
