Ulna collateral ligament
Definition
Injury to ulnar collateral ligament of thumb MCPJ
Interferes with pinch grip and grasp and thumb is ineffective as a post
Injury to ulnar collateral ligament of thumb MCPJ
Interferes with pinch grip and grasp and thumb is ineffective as a post
Operative v Nonoperative
Levy et al Arthroscopy 2009
- systematic Review
- improved outcomes with operative management
https://pubmed.ncbi.nlm.nih.gov/19341932/
Vicenti et al. Injury 2019
- systematic review
- two studies compare operative v nonoperative
Middle age men
Steroids / Growth Hormone
Usually occurs in gym
Bench Press
Significant bruising in the acute phase
In chronic setting, ask patient to adduct against hip / resistance
Usually occurs in patients over 60
- due to decreased vascularity & collagen weakness
Younger patient on steroids / growth hormone
Occasionally occurs in young athlete with excessive contracture
Often preceded by quadriceps tendinosis
1. Acute < 3/52
- single bundle
2. Chronic
- double bundle
Set up
- knee at 90 degrees on bolster
- x-ray getting lateral of knee
Usually occurs in young people
- often previous history of tendonitis ± steroid injections
Usually at level of inferior pole of patella
- less common at tibial tubercle
- mid-substance ruptures rare
Severe pain
Palpable defect
Extensor deficit / unable to SLR
Patella alta / high riding patella
Limb alignment
Risk that late posterolateral corner reconstruction will fail in the setting of the varus knee
- varus knee alignment and varus thrust in stance phase
- consider osteotomy first in this setting
Posterolateral Corner Reconstruction
Moulton et al. Am J Sports Med 2016
- systematic review of PCL reconstruction for chronic injuries
- 450 patients