Gamekeeper Thumb Stenner Lesion
Forceful deviation of the thumb in a radial direction can cause tearing of the ulnar collateral ligament of the metacarpi-phalangeal joint. This results in pain and instability. The ligament most frequently tears off the base of the proximal phalanx with or without a piece of bone. If a large piece of bone is involved and/or is displaced surgery is needed for correction. If no significant displacement is evident this could heal with just a period of immobilization. If the ligament pulls out from under the sagittal band creating a Stenner lesion this injury can not heal without surgery since the end of the ligament is not near its normal insertion.
The ligament has been re-attached to the base of the proximal phalanx with a pullout stich placed through the bone and tied over a button on the radial side of the thumb. The joint has been immobilized protecting the repair with K-wires.