Gamekeeper thumb: identification of the Stener lesion with US.

Abstract

To determine the value of ultrasound (US) in recognizing the ligamentary dislocation occasionally associated with gamekeeper thumb (Stener lesion). Detecting such dislocations is important because they require surgical repair, whereas nondisplaced ruptured ligaments respond to conservative treatment. This dislocation cannot be reliably diagnosed with standard methods, leading to unnecessary surgical procedures. Forty-eight hyperabduction injuries of the thumb were included. The thumbs were either unstable or unexaminable because of tenderness. No fractures were seen on standard radiographs. Sonograms were positive in 13 patients, who then underwent surgery. A Stener lesion was found in 10 patients and a partial Stener lesion in three. Three patients with negative sonograms also underwent surgery, and no dislocation was found. The other 32 patients with negative US findings were treated conservatively, and none developed subsequent instability. US proved to be a reliable, simple, and easily reproducible tool for recognition of the Stener lesion.