Updated: 9/28/2018

Digital Collateral Ligament Injury

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https://upload.orthobullets.com/topic/6039/images/mri collateral lig.jpg
Introduction
  • Trauma to the digit injuring the radial or ulnar collateral ligaments
  • 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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