Adductor pollicis and Dorsal interossei hyper stretch Injury- Chronic condition

[Arunptindia]

Here's a case of an injury at the first web space in the left hand as this Pediatrician forcibly hit his Index finger's lateral side on the edge of the table, two years ago.

The force could have stretched First Dorsal Interossei and simultaneously the forcibly outstretched (abducted) thumb must have stretched the origin of transverse head of Adductor pollicis.

Since the Injury , i.e for the past 2 years, he has pain when index finger is hyperflexed at MCP joint.
There is a mild fullness at the second MCP region at the palmar aspect of the hand since the time of injury.

Initially it was treated with NSAIDS and Rest. Recently, for the past one month, the person is undergoing Trigger release for Adductor Pollicis. He is also getting Ultrasound therapy for the past ten days.

The person experiences pain when the Index finger is hyper-flexed at the MCP joint. This pain gets relieved when the Adductor Pollicis muscle is released and also when the Index finger is flexed with the the thumb in opposition position.

Kindly suggest a solution. Thank You.

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[anka_nikoleta]

Dear Arun,

He could have torn his ulnar collateral injury (UCL) -thumb and in acute phase a splinting would have been one of the ways to manage.
In complete ruptures,t he adductor policis ms can interpose between the fragments and hinder the ligament healing- so called Stener lesion and results in permanent instability at the MCP joint.

So can take in consideration a possible Stener lesion if sympts don't improve and refer the patient onto a Hand Surgeon. This is an indication for surgical repair

I hope this helps.

Kindly,

Nicoleta

- - - Updated - - -

Dear Collegue,

Please see the next link:
http://www.bssh.ac.uk/patients/conditions/32/skiers_thumb

[Arunptindia]

Thank You Nicoleta, I would look into such a possibility..