Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute right thumb pain following a forced abduction injury to the MCP joint. Reports localized pain, swelling, and weakness with pinch grip. Denies numbness or paresthesia. Mechanism of injury consistent with valgus stress to the thumb.
Clinical Examination Findings
Right thumb MCP joint exhibits localized swelling and ecchymosis over the ulnar aspect. Tenderness to palpation along the ulnar collateral ligament (UCL). Valgus stress testing at 0 and 30 degrees of flexion reveals increased laxity compared to the contralateral side, with loss of firm endpoint. No neurovascular deficit noted; capillary refill <2 seconds.
Treatment Protocol
Immobilization in a thumb spica splint/cast for 4-6 weeks to allow ligamentous healing. Ice application for 20 minutes every 2-3 hours. Elevation of the right hand. NSAIDs for pain and inflammation management. Referral to hand surgery for assessment of potential Stener lesion or complete rupture.