A 22-year-old skier falls and sustains a valgus injury to the thumb metacarpophalangeal joint. Examination reveals marked instability on valgus stress with no endpoint. Ultrasound shows the ulnar collateral ligament retracted proximal to the adductor aponeurosis (Stener lesion). The definitive management is:

• A Surgical repair of the ulnar collateral ligament ✓
• B Thumb spica cast immobilization for 6 weeks
• C Ulnar nerve block and repeat stress radiograph in 2 weeks
• D Arthrodesis of the MCP joint

Explanation

B Stener lesion occurs when the adductor aponeurosis interposes between the ruptured ulnar collateral ligament and its insertion, preventing healing. It requires surgical repair. Cast immobilization is appropriate only for partial tears without Stener lesion or non-displaced sprains.

Reference: Green's Operative Hand Surgery, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.