Metacarpophalangeal ulnar ligament rupture
Revision as of 11:50, 1 June 2015 by Rossdonaldson1 (talk | contribs) (Created page with "==Background== *Also known as gamekeeper's thumb or skier's thumb *Ulnar ligament ruptures at insertion into proximal phalanx (due to radial deviation of MCP) ==Clinical Feat...")
Background
- Also known as gamekeeper's thumb or skier's thumb
- Ulnar ligament ruptures at insertion into proximal phalanx (due to radial deviation of MCP)
Clinical Features
- Swelling and localized tenderness over ulnar border of joint
- Weakness of pinch
Differential Diagnosis
Diagnosis
- X-ray (perform before joint stressing)
- Bony avulsion from insertion of UCL into proximal phalanx
- Associated condylar fracture
- Proximal phalanx volar subluxation and radial deviation suggests complete UCL rupture
Partial versus complete rupture
- Valgus stress testing with joint in full extension and in 30 deg of flexion
- >35 deg of joint laxity or 15 deg of laxity beyond that present in uninjured thumb is consistent w/ complete UCL rupture
Management
- Partial rupture
- Immobilize in thumb spica for 4wk
- Full rupture
- Referral within 1wk