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Clinical Testing of Ulnar Collateral Ligament Injuries of the ThumbFrom the Department of Hand Surgery, University College London Hospital, London, UK Correspondence: A. K. Malik Apt 22 Meridian Court, 7 East Lane, Bermondsey, London, SE16 4UF, UK. Tel.: +44 (0)20 7380 9293; fax: +44 (0)20 7380 9081. E-mail:akmalik100{at}hotmail.com. 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° of flexion. In 34% of subjects there was a difference of 10° or more between right and left thumbs in extension, and 12% had a difference of at least 15°. In flexion, 22% of thumbs differed by 10° or more and 3% by 15° 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 Words: collateral • injury • ligament • testing • ulnar
This version was published on June
1, 2009 Journal of Hand Surgery (European Volume), Vol. 34, No. 3,
363-366 (2009) |
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