Updated: 5/14/2021

Digital Collateral Ligament Injury

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  • summary
    • Digital Collateral Ligament Injuries result from direct trauma to the digit injuring the radial or ulnar collateral ligaments.
    • Diagnosis is made clinically and MRI may be required for confirmation.
    • Treatment is nonoperative with buddy splinting with the exception of radial collateral injury to the index finger which requires surgical repair.
  • Epidemiology 
    • Incidence
      • rare
        • < 1 per 100,000 annually
  • Etiology
    • Mechanism
      • depends on the joint involved
      • usually the result of a "jammed finger"
      • doral or volar dislocation events can tear one or both of the collateral ligaments
  • Anatomy
    • Collateral ligaments of the digits
      • located on the lateral aspect of the DIP, PIP and MCP joints
      • crucial for opposing pinch stability
  • Presentation
    • Symptoms
      • pain at involved joint
      • instabilty with pinch once pain resolved
    • Physical exam
      • inspection
        • swelling at involved joint
        • deformity of joint
      • provocative tests
        • varus and valgus stress tests
  • Imaging
    • Radiographs
      • recommended views
        • PA
        • lateral
        • oblique
        • varus/valgus stress views may aid in diagnosis
    • MRI
      • indicated if equivocal physical exam findings
  • Treatment
    • Nonoperative
      • buddy taping for 3 weeks
        • indications
          • simple tears
      • buddy taping for 6 weeks
        • indications
          • complete tears
    • Operative
      • collateral ligament repair
        • indications
          • radial ligament injuries of index finger (ligament needed for pinch stability)
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