Injury of the ulnar collateral ligament of the metacarpophalangeal joint of the thumb
Introduction
Brief introduction of ulnar collateral ligament injury of the metacarpophalangeal joint of the thumb The most common ligament injury in the hand is the ulnar collateral ligament injury of the metacarpophalangeal joint of the thumb, which often results in loss of thumb-to-finger force and fine finger-pinch. In 1961, Weller confirmed that this was a particularly common type of injury in skiing. Cantero, Reill and Karutz had 53% and 57% of skiing, respectively. Therefore, this injury is also called ski thumb. The metacarpophalangeal joint is a single hinged joint with an average flexion and extension of 10° to 60°. The axis of rotation of the joint is eccentric. There are two strong collateral ligaments on both sides of the joint capsule, namely the intrinsic lateral collateral ligament and the accessory collateral ligament, which maintain the passive stability of the joint. The intrinsic lateral collateral ligament travels from the dorsolateral side of the first metacarpal head to the distal volar, and terminates at the lateral nodule of the base of the proximal phalanx. It is 4 to 8 mm wide and 12 to 14 mm long. It is quite thick and can withstand an external force of 30 to 40 kg. The accessory collateral ligament from the volar side of the inferior collateral ligament of the first metacarpal sac, partially over the volar sesamoid to the volar cartilage, is tense when the joint is straight. basic knowledge The proportion of illness: 0.008% Susceptible people: no special people Mode of infection: non-infectious Complications: swelling
Cause
Causes of ulnar collateral ligament injury of the metacarpophalangeal joint of the thumb
(1) Causes of the disease
Mostly caused by the abduction, rotation and overextension of the thumb.
(two) pathogenesis
The ulnar collateral ligament injury of the metacarpophalangeal joint of the thumb can be caused by the abduction, rotation and overextension of the thumb. In the case of ski injury, it is caused by the incorrect grip of the snow stick; when playing, especially when catching the ball It may be caused by the direct trauma of the ball. The use of a cane can also cause chronic damage. When the hand falls, the thumb in the outreach position makes the ulnar side collateral ligament overweight, and the ski handle is heavier between the thumb and forefinger. With this load, the degree of ligament damage depends mainly on the direction of the force, the position at which the thumb is at the moment and the pressure on the joint. There are generally three types of collateral ligament rupture caused by external force:
1. Break near the distal stop.
2. The distal small bone piece is avulsed.
3. The middle of the ligament is broken.
Prevention
Prevention of ulnar collateral ligament injury of the metacarpophalangeal joint of the thumb
There is no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease.
Complication
Complications of ulnar collateral ligament injury of the metacarpophalangeal joint of the thumb Complications swelling
Swelling occurred locally after swelling and trauma, peaked after 72 hours, after which the swelling gradually subsided. After swelling occurs, the affected limb should be raised, preferably above the plane of the heart, and appropriate ice should be given to promote swelling.
Symptom
Thumb metacarpophalangeal joint ulnar collateral ligament injury symptoms common symptoms thumb unexplained pain pain thumb adduction deformity severe pain ligament rupture thumb sign radiation pain
There is a typical history of trauma, pain on the injured side of the metacarpophalangeal joint, swelling, mostly accompanied by local subcutaneous bruising, limited movement, local tenderness, especially in the lateral movement of the metacarpophalangeal joint can cause severe pain.
Normally, the thumb metacarpophalangeal joint is about 25° outward, which is a reliable sign of collateral ligament rupture. If the joint can be turned in the extension position, it indicates that the palmar and collateral ligaments have been broken; such as mild flexion The valgus of the joint is about 20°, indicating that only the collateral ligament is damaged. In the case of old ligament injury, the skin god walking in the scar area often causes radioactive pain.
When the thumb metacarpophalangeal joint is positive and the lateral X-ray film is accompanied by the avulsion of the bony ligament, the size and location of the bone piece can be determined, which provides a reference for the choice of clinical treatment methods.
Examine
Examination of the ulnar collateral ligament injury of the metacarpophalangeal joint of the thumb
The thumb metacarpophalangeal joint is a positive, lateral X-ray film, and a fracture piece with avulsion can be found.
Diagnosis
Diagnosis and diagnosis of ulnar collateral ligament injury of the metacarpophalangeal joint of the thumb
Typical history of trauma, pain in the injured side of the metacarpophalangeal joint, swelling, subcutaneous bruising, dysfunction, local tenderness, exercise can cause severe pain, X-ray examination, visible avulsion fractures.
This disease is generally not confused with other diseases.
