Clinical Testing of Ulnar Collateral Ligament Injuries of the Thumb

Abstract

The diagnosis of complete tears of the ulnar collateral ligament of the thumb metacarpophalangeal (MP) joint depends on demonstration of excessive laxity of the ligament, but there is controversy on whether laxity greater than a certain cut-off value or laxity greater than the opposite thumb is the criterion for diagnosis. We examined 200 thumbs of 100 normal individuals in extension and in 30 degrees of flexion. In 34% of subjects there was a difference of 10 degrees or more between right and left thumbs in extension, and 12% had a difference of at least 15 degrees. In flexion, 22% of thumbs differed by 10 degrees or more and 3% by 15 degrees or more. Comparison with the uninjured contralateral thumb is unreliable in many individuals. We recommend the lack of a definite end point on stress examination as indicating complete rupture of the ulnar collateral ligament.

Key MR Imaging Features of Common Hand Surgery Conditions

“…Laxity greater than 35 in MCP joint extension is suggestive of an accessory UCL and volar plate injury. 54,55 Volar subluxation of the MCP joint is additionally suggestive of a complete tear with dorsal capsule disruption. The presence of fullness or a palpable mass on the ulnar aspect of the metacarpal head and neck is suggestive of a Stener lesion 54 (Fig.…”

Return to Football and Long-Term Clinical Outcomes After Thumb Ulnar Collateral Ligament Suture Anchor Repair in Collegiate Athletes

“…Patients were deemed to have a complete rupture of the UCL if they presented with pain and tenderness over the ulnar aspect of the thumb MCP joint with an absence of a solid end point with passive stress testing of the UCL at full MCP joint extension and at 30 MCP joint flexion. 23 Surgical reports were reviewed to determine whether a Stener lesion was present. 24 Stress radiography compared with the uninjured side was used to supplement the diagnosis in many but not all cases.…”

Thumb collateral ligament injuries in the athlete

“…Parameters to record are the degrees of valgus laxity in full extension and 30°flexion, injured and contralateral, and presence of an end point. Laxity of 30°, increased laxity of 15°compared to the contralateral side, or lack of endpoint signify injury [17][18][19]. Laxity in full extension indicates accessory UCL or volar plate tear and in 30°flexion, tear of the proper UCL.…”