Abstract
The Stener lesion of the ulnar collateral ligament of the metacarpophalangeal (MP) joint of the thumb is characterized by an interposition of the adductor aponeurosis between a distally avulsed ligament and its insertion into the base of the proximal phalanx. Other cases of Stener-like lesions have been described and are always identified by the interposition of a tendon or parts of it between the two ends of the injured ligament, which would restrain its healing. Surgical management of these injuries is indicated to avoid the poor long-term outcomes of the conservative management. We hereby report the case of a 42 years old male patient who attended our outpatient clinic in may 2019. He had sustained a traumatic injury during an altercation 20 days earlier which had resulted in a proximal interphalangeal joint (PIPJ) dislocation which was reduced by the patient himself. The US scan showed a lesion of the transverse retinaculum of the extensor tendon. This lesion had caused a diastasis between the central slip and the ulnar lateral band. The ulnar lateral band was blocked between the two ends of the ulnar collateral ligament, delaying the healing of the ulnar collateral ligament. Surgery was performed based on the Stener-like lesion found on the ultrasonography scan. The patient was followed up after surgery, underwent physiotherapy and his range of motion and function improved. Our experience shows that timely recognition of a Stener or Stener -like lesion allows early surgical treatment and provides healing and better functional outcomes on the long term compared to conservative treatment. Also, osteoarticular ultrasonography is an invaluable tool for early recognition of Stener or Stener-like lesions in the emergency setting.
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