A narrative review by Tang (2011) covering the anatomy, diagnosis, and management of UCL and RCL injuries of the thumb MP joint. It addresses how to distinguish partial from complete tears on stress examination and how to select between nonsurgical immobilization, acute repair, delayed reconstruction, and arthrodesis.
When you stress-test a thumb MP joint after a radial deviation injury, angulation >30°–35° or absence of a firm end point confirms grade 3 UCL tear — get them to the OR, because ~90% will have a Stener lesion that won't heal without repair.
For RCL injuries, also assess volar drawer, as subluxation >3 mm is far more common than with UCL tears and influences the decision to pin the joint after repair.
A narrative review by Tang (2011) covering the anatomy, diagnosis, and management of UCL and RCL injuries of the thumb MP joint. It addresses how to distinguish partial from complete tears on stress examination and how to select between nonsurgical immobilization, acute repair, delayed reconstruction, and arthrodesis.
When you stress-test a thumb MP joint after a radial deviation injury, angulation >30°–35° or absence of a firm end point confirms grade 3 UCL tear — get them to the OR, because ~90% will have a Stener lesion that won't heal without repair.
For RCL injuries, also assess volar drawer, as subluxation >3 mm is far more common than with UCL tears and influences the decision to pin the joint after repair.