[US of the ulnal collateral ligament (UCL) at the first metacarpophalangeal (MCP) joint: a new dynamic maneuver to detect Stener lesions].
Sprain of the first MCP joint is frequent. In patients with UCL tear, the adductor aponeurosis may become interposed between the distal site of ligament attachment and the ruptured ligament: this lesion, described by Stener, prevents ligamentous healing and requires surgical intervention. We present the results from a prospective study of 56 patients with first MCP sprain in order to determine the value of US by correlating with surgical findings. We propose a new dynamic maneuver during flexion-extension of the IP joint. This enables visualization of the adductor aponeurosis and its relationship to the UCL on US allowing detection of a Stener lesion when it exists. All patients with Stener lesion on US underwent surgery (32 operated patients): the sensitivity of US was 95.4% with a specificity of 80% for detection of Stener lesions. US, with the use of this specific dynamic maneuver is a reliable and reproducible tool for detecting Stener lesions. Review of video recordings allows visual comprehension of the examination for other health care providers.
Bordet
B
B
Service d'Imagerie médicale, Département de Chirurgie de la main, Clinique du Parc, 155, bis boulevard Stalingrad, 69006 Lyon. bertrandbordet@voila.fr
Borne
J
J
Fantino
O
O
Pialat
J B
JB
D000328:Adult; D005260:Female; D006801:Humans; D008023:Ligaments, Articular / Q000000981:diagnostic imaging*; D008297:Male; D008662:Metacarpophalangeal Joint; D011446:Prospective Studies; D013180:Sprains and Strains / Q000000981:diagnostic imaging*; D014463:Ultrasonography