Presentation
History of fall on the ground while walking - 9 days ago. Complaining of thumb base pain. Thumb radiograph demonstrated no fracture or dislocation.
Patient Data
Symptomatic side shows absence of ulnar collateral ligament in normal location. There is a hypoechoic pseudomass formation proximal to joint line; abutting metacarpal bone. There is no associated bone flake avulsion or defect in phalanx base. There was no sesamoid fracture at thumb. Flexure and extensor tendon were normal.
Asymptomatic side shows normal position and echopattern of ulnar collateral ligament.
Case Discussion
This patient presented with thumb trauma due to a fall on the ground. Ultrasound shows an absent ulnar collateral ligament along with the formation of a hypoechoic pseudomass abutting metacarpal bone. When the ruptured ligament is displaced over adductor pollicis aponeurosis; there is a pseudomass formation proximal to the joint line and abutting metacarpal bone. It is called a Stener lesion. No surgical follow-up is available.
Ulnar collateral ligament of the thumb shows three types of injury:
Avulsion of distal end of ligament along with a bone flake. There is easily seen on radiographs.
Tear of the collateral ligament (usually the distal end) with a ligament in situ - deep to adductor pollicis aponeurosis. There is no pseudomass formation in this case.
Ruptured and displaced ligament over aponeurosis forming a pseudomass. It is known as a Stener lesion. This requires surgical treatment.
Unable to process the form. Check for errors and try again.