Evidence brief
Surgical Treatment of Thumb UCL Injuries
Stener lesion prevents healing with conservative treatment
Complete tears with instability require surgery
Adductor aponeurosis interposition is key finding
Chronic injuries may need reconstruction
MRI or ultrasound can confirm Stener lesion
Stener lesion (ligament displaced superficial to adductor aponeurosis) mandates surgical treatment. Clinical examination with stress testing guides management.
Classic exam topic. Know anatomy: UCL attaches to proximal phalanx base, adductor aponeurosis overlies. Stener lesion = displaced UCL cannot heal without surgery. Examination: >30° laxity or no endpoint = complete tear. Imaging: ultrasound or MRI for Stener. Surgery: anchor repair or reconstruction.
Campbell CS. Gamekeeper's thumb. J Bone Joint Surg Br. 1955;37-B(1):148-149.
Level IV
Case series or case reports