gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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The Stener-like lesion of the radial collateral ligament of the thumb. An anatomic study

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  • presenting/speaker Rafael Jakubietz - Universitätsklinikum Würzburg, Würzburg, Germany
  • Fabian Gilbert - Universitätsklinikum Würzburg, Würzburg, Germany
  • Sylvia Bernuth - Universitätsklinikum Würzburg, Würzburg, Germany
  • Michael Jakubietz - Universitätsklinikum Würzburg, Würzburg, Germany
  • Rainer Meffert - Universitätsklinikum Würzburg, Würzburg, Germany

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-764

doi: 10.3205/19ifssh0623, urn:nbn:de:0183-19ifssh06238

Published: February 6, 2020

© 2020 Jakubietz et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: Injury to the radial collateral ligament of the thumb is less common than on the ulnar side and often diagnosed in the chronic state. The counterpart of the Stener lesion on the radial side is very uncommon and only few reports in the literature can be found. The aim of this cadaver study was to evaluate the anatomy of the radial collateral ligament in relation to the surrounding structures.

Methods: 5 cadaver thumbs from participants of the willed body program were dissected. After splitting the EPL tendon the capsule was exposed and the radial collateral ligament was transected distally. After closure of the EPL tendon ulnar displacement of the first MCP joint was performed until the proximal stump penetrated the space between the EP L and APB tendon. This was repeated in full extension, 30 and 45 degrees of flexion.

Results: In the position of 45° of MCP flexion a ulnar stress of 30° caused a Stener-like lesion of the radial collateral ligament of the thumb in full extension the fascial alignment of the EPL and APB remained tight and no Stener-like lesion was seen.

Conclusion:On the radial side of the thumb increased flexion of the MCP joint in combination with ulnar stress increase the chance of creating a stinger-like lesion. During flexion of the MCP joint the fascial alignment between the EPL and APB tendon seems to widen which may predispose the distally ruptured radial collateral ligament to be loaded upon the extensor hood between the EPL and APB tendon when the radial stress is reversed into the neutral position.