Dear Sir, Rupture of the ulnar collateral ligament (UCL) of the thumb metacarpophalangeal (MP) joint is common. When complete disruption of the UCL occurs, the adductor aponeurosis may become interposed between the ends of the torn collateral ligament (Stener lesion) preventing adequate healing of the ligament (Stener, 1962). There are various tests to evaluate UCL injuries, including stress radiographs, ultrasound scans, arthrograms, and magnetic resonance imaging scans. On posteroanterior (PA) stress radiographs, the angle made by the long axis of the proximal phalanx relative to the long axis of the metacarpal bone is the 'stress angle'. This angle can be compared between the injured and uninjured sides and the difference measured. A Stener lesion is thought to be present when the difference between the stress angles is 10° or more (Bowers and Hurst, 1977; Kozin and Bishop, 1994).
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