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Abstract
Ligamentous injury of the metacarpophalangeal (M.C.P) joint of the thumb is common and is related to marked instability of the joint if left untreated. The ulnar and radial collateral ligaments are the major stabilizers of the metacarpophalangeal joint during opposition and grip. Injuries to the radial collateral ligament of the thumb metacarpophalangeal joint are less common than injuries to the ulnar side (Horch et al, 2006).
The most frequently encountered lesion is a sprain of the ulnar collateral ligament( UCL). Delay in the diagnosis, treatment failure, or progressive attenuation of the ligament complex may lead to chronic disability of the M.C.P joint. Patients with chronic instability may be managed with ligament reconstruction (Guelmi et al, 2003).
Chronic injury of UCL in Scottish gamekeepers, who sustained the injury by breaking the necks of injured hares. UCL injury occurs most often and with increasing frequency in skiers who fall holding onto ski poles, resulting in the term “skier’s thumb”. It is also very common among basketball players and in grappling sports like wrestling and the martial arts (Dey &Green, 2003).
The M.C.P joint is not a hinge joint but a condylar joint (Schmidt & Lanz, 2004). It is primarily involved in flexion and extension, but also allows some rotation, adduction, and abduction. Joint stability is provided by static restraints and dynamic stabilizers. Plain X rays are useful in confirming the diagnosis (Heyman, 1997).
Magnetic resonance imaging (MRI), because of its excellent soft-tissue resonance and multiplanar capabilities, has been advocated as a means for assessing UCL injuries (Romano, 2003).