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Abstract
Over 10 years in our unit, 127 patients underwent surgical repair of an acute thumb
ulnar collateral ligament (UCL) rupture for clinically unstable injuries or displaced
avulsion fractures. Ultrasound was used when clinical diagnosis was uncertain. The
male/female ratio was 3:2, with a mean age of 40 years (range: 12-81 years). Most
of them (> or =66%) were hyper-extension/abduction injuries. The most common cause
was a fall (49%), followed by sports injuries; skiing accounted for only 2.4%. Ultrasound
was 92% sensitive for UCL ruptures (positive predictive value (PPV) 99%). Over 99%
of patients had a UCL rupture confirmed at surgery. Other findings included avulsion
fractures (21%), dorsal capsular tears (57%) and dorsal capsule infolding (29%). The
most common surgical complication was neurapraxia (6.5%). In our population, thumb
UCL injuries are rarely caused by skiing. Ultrasound is a useful, sensitive adjunct
in acute diagnosis. Dorsal capsular tears and joint interposition are common. Surgery
provides excellent results with few long-term complications.