Ishizuki Masafumi, Sugihara Takayuki, Wakabayashi Yoshiaki, Shirasaka Ritsurou, Aoyama Hiromichi
Department of Orthopaedic Surgery, Tsuchiura Kyodo General Hospital, 11-7 Manabeshinmachi, Tsuchiura-shi, Ibaraki, 300-0053, Japan.
J Orthop Sci. 2009 Mar;14(2):150-4. doi: 10.1007/s00776-008-1301-z. Epub 2009 Apr 1.
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. Stener-like lesions of the MP joint of the finger have been previously reported in only a few cases.
The authors experienced 38 cases of collateral ligament injuries of the MP joint of the finger. The two most frequently affected sites were the radial side of the little finger (21 cases) and the radial side of the ring finger (8 cases). We have previously reported some of these cases (22 cases), as well as clinical features and arthrographic findings. One Stener-like lesion in a collateral ligament injury of the MP joint of the ring finger was also reported earlier (Ishizuki, 1988). Additionally, Stener-like lesions were found postoperatively in six of eight cases surgically treated for collateral ligament injuries of the MP joint of the finger (little finger involvement in 5 cases and long finger involvement in 1 case).
We experienced six cases of a Stener-like lesion of the MP joint of the finger. In five of these cases the distally avulsed collateral ligament was trapped by the opened window of the injured sagittal band. In the other case the ligament was avulsed at a proximal site, and the ruptured end was trapped by the sagittal band. All of the little fingers involving Stener-like lesions were abducted and unable to adduct. Therefore, an abducted little finger is an important sign of this lesion and is considered to warrant surgical treatment. Arthrograms provided information useful for identifying the lesions. In the radial three fingers, palpation of the tumor at the level of the collateral ligament may also be an important examining tool for identifying a displaced ruptured collateral ligament of the MP joint of the finger.
We experienced six cases of Stener-like lesions of the MP joint of the finger. In all cases, the avulsed collateral ligament was trapped by the ruptured sagittal band. Surgical treatment was thought to be indicated in these cases. Therefore, it is important to avoid overlooking Stener-like lesions of the MP joint of the finger.
拇指掌指（MP）关节尺侧副韧带的斯滕纳（Stener）损伤的特征是，在远侧撕脱的韧带与其在近节指骨基底的附着点之间夹入了内收肌腱膜。手指MP关节的类斯滕纳损伤此前仅有少数病例报道。
作者经手了38例手指MP关节侧副韧带损伤病例。其中最常受累的两个部位是小指桡侧（21例）和环指桡侧（8例）。作者此前已报道过其中部分病例（22例）以及临床特征和关节造影结果。此前还报道过1例环指MP关节侧副韧带损伤中的类斯滕纳损伤（石月，1988年）。此外，在接受手术治疗的8例手指MP关节侧副韧带损伤病例中，术后发现有6例存在类斯滕纳损伤（小指受累5例，中指受累1例）。
作者经手了6例手指MP关节的类斯滕纳损伤病例。其中5例远侧撕脱的侧副韧带被损伤的矢状带打开的窗口卡住。另一例韧带在近端部位撕脱，断裂端被矢状带卡住。所有存在类斯滕纳损伤的小指均处于外展位且无法内收。因此，小指外展是该损伤的一个重要体征，被认为有手术治疗的必要。关节造影提供了有助于识别损伤的信息。在桡侧三个手指中，在侧副韧带水平触诊肿物也可能是识别手指MP关节移位断裂侧副韧带的一项重要检查手段。
作者经手了6例手指MP关节的类斯滕纳损伤病例。所有病例中，撕脱的侧副韧带均被断裂的矢状带卡住。这些病例被认为需要手术治疗。因此，避免漏诊手指MP关节的类斯滕纳损伤很重要。
