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Injury at the Thumb UCL: Is There a Stener Lesion?

      A 24-year-old, right-handed medical student sustains a “ski pole” injury to his right thumb 1 month after matching into a surgical residency. He is swollen and tender at the ulnar collateral ligament (UCL) of the metacarpophalangeal (MCP) joint of the thumb. There is 35° of angulation at the MCP joint when valgus stress is applied in 30° of flexion. Static radiographic examination shows no fracture. The patient has reviewed all the current literature on treatment of UCL injury of the thumb MCP joint, discussed it with you, and decided that, unless there is a Stener lesion (displacement of the UCL superficial to the adductor aponeurosis), he will elect nonsurgical treatment.
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