Skip to main content
SpringerLink
Log in

Sexual dimorphism in the anatomy of the ulnar collateral thumb ligament

  • original article
  • Published:
Wiener klinische Wochenschrift Aims and scope Submit manuscript

Summary

Background

Treatment of ruptured ulnar collateral thumb metacarpophalangeal (MCP) joint ligaments (UCL) necessitate a profound anatomic knowledge for optimal surgical repair in order to preserve range of motion and ensure postoperative joint stability. Therefore, knowledge of the angle between the UCL and the longitudinal axis of the first metacarpal bone could be useful.

Methods

In this study 46 ulnar collateral thumb MCP joint ligaments in 15 male and 15 female embalmed anatomic specimens were dissected and the angles between the longitudinal axis of the first metacarpal bone and the proper (PUCL) as well as the accessory ulnar collateral thumb MCP ligament (AUCL) were measured.

Results

In male specimens the angle for the PUCL measured on average 133.5° (±2.35°) and 122.75° (±3.8°) for the AUCL. A significantly different angle was measured for female specimens which showed on average 137.88° (±3.51°) for the PUCL and 128.65° (±4.14°) for the AUCL.

Conclusions

Optimal surgical repair or reconstruction of torn ulnar collateral thumb MCP joint ligaments should aim for an angle of approximately 135° in PUCL and 126° in AUCL in relation to the longitudinal axis of the metacarpal bone. Differences in men and women should be considered if possible.

Level of evidence

IV (anatomic study).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Fritsche E, De Monaco D, Drinkuth S, von Wartburg U. Simultaneous avulsion fracture of the insertion of the ulnar and radial collateral ligaments of the metacarpophalangeal joint of the thumb. Br J Plast Surg. 2000;53(2):168–70.

    Article  CAS  Google Scholar 

  2. Samora JB, Harris JD, Griesser MJ, Ruff ME, Awan HM. Outcomes after injury to the thumb ulnar collateral ligament—A systematic review. Clin J Sport Med. 2013;23(4):247–54.

    Article  Google Scholar 

  3. Bailie DS, Benson LS, Marymont JV. Proximal interphalangeal joint injuries of the hand. Part I: Anatomy and diagnosis. Am J Orthop. 1996;25(7):474–7.

    CAS  PubMed  Google Scholar 

  4. Benson LS, Bailie DS. Proximal interphalangeal joint injuries of the hand. Part II: Treatment and complications. Am J Orthop. 1996;25(8):527–30.

    CAS  PubMed  Google Scholar 

  5. Aldrian S, Valentin P, Wondrasch B, Krusche-Mandl I, Ostermann RC, Platzer P, et al. Gender differences following computer-navigated single- and double-bundle anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2014;22(9):2145–52.

    Article  CAS  Google Scholar 

  6. Heyman P, Gelberman RH, Duncan K, Hipp JA. Injuries of the ulnar collateral ligament of the thumb metacarpophalangeal joint. Biomechanical and prospective clinical studies on the usefulness of valgus stress testing. Clin Orthop Relat Res. 1993;292:165–71.

    Article  Google Scholar 

  7. Minami A, An KN, Cooney WP 3rd, Linscheid RL, Chao EY. Ligamentous structures of the metacarpophalangeal joint: A quantitative anatomic study. J Orthop Res. 1984;1(4):361–8.

    Article  CAS  Google Scholar 

  8. Fraser B, Veitch J, Firoozbakhsh K. Assessment of rotational instability with disruption of the accessory collateral ligament of the thumb MCP joint: A biomechanical study. Hand. 2008;3(3):224–8.

    Article  Google Scholar 

  9. Carlson MG, Warner KK, Meyers KN, Hearns KA, Kok PL. Anatomy of the thumb metacarpophalangeal ulnar and radial collateral ligaments. J Hand Surg Am. 2012;37(10):2021–6.

    Article  Google Scholar 

  10. Tsiouri C, Hayton MJ, Baratz M. Injury to the ulnar collateral ligament of the thumb. Hand. 2009;4(1):12–8.

    Article  Google Scholar 

  11. Campbell CS. Gamekeeper’s thumb. J Bone Joint Surg Br. 1955; https://doi.org/10.1302/0301-620X.37B1.148.

    Article  PubMed  Google Scholar 

  12. Derkash RS, Matyas JR, Weaver JK, Oden RR, Kirk RE, Freeman JR, et al. Acute surgical repair of the skier’s thumb. Clin Orthop Relat Res. 1987;216:29–33.

    Google Scholar 

  13. Kaplan SJ. The Stener lesion revisited: A case report. J Hand Surg Am. 1998;23(5):833–6.

    Article  CAS  Google Scholar 

  14. Jones S, Crawford I. Towards evidence based emergency medicine: Best BETs from the Manchester Royal Infirmary. Plaster or functional splint in gamekeepers thumb. Emerg Med J. 2002;19(4):324.

    Article  Google Scholar 

  15. Crowley TP, Stevenson S, Taghizadeh R, Addison P, Milner RH. Early active mobilization following UCL repair with Mitek bone anchor. Tech Hand Up Extrem Surg. 2013;17(3):124–7.

    PubMed  Google Scholar 

  16. Gluck JS, Balutis EC, Glickel SZ. Thumb ligament injuries. J Hand Surg Am. 2015;40(4):835–42.

    Article  Google Scholar 

  17. Smith RJ. Post-traumatic instability of the metacarpophalangeal joint of the thumb. J Bone Joint Surg Am. 1977;59(1):14–21.

    Article  CAS  Google Scholar 

  18. Bean CH, Tencer AF, Trumble TE. The effect of thumb metacarpophalangeal ulnar collateral ligament attachment site on joint range of motion: An in vitro study. J Hand Surg Am. 1999;24(2):283–7.

    Article  CAS  Google Scholar 

  19. Baskies MA, Lee SK. Evaluation and treatment of injuries of the ulnar collateral ligament of the thumb metacarpophalangeal joint. Bull NYU Hosp Jt Dis. 2009;67(1):68–74.

    PubMed  Google Scholar 

  20. Rhee PC, Jones DB, Kakar S. Management of thumb metacarpophalangeal ulnar collateral ligament injuries. J Bone Joint Surg Am. 2012;94(21):2005–12.

    Article  Google Scholar 

  21. Carlson MG, Warner KK, Meyers KN, Hearns KA, Kok PL. Mechanics of an anatomical reconstruction for the thumb metacarpophalangeal collateral ligaments. J Hand Surg Am. 2013;38(1):117–23.

    Article  Google Scholar 

  22. Lee SK, Kubiak EN, Lawler E, Iesaka K, Liporace FA, Green SM. Thumb metacarpophalangeal ulnar collateral ligament injuries: A biomechanical simulation study of four static reconstructions. J Hand Surg Am. 2005;30(5):1056–60.

    Article  Google Scholar 

  23. Boesmueller S, Huf W, Rettl G, Dahm F, Meznik A, Muschitz G, et al. The influence of sex and trauma impact on the rupture site of the ulnar collateral ligament of the thumb. PLoS ONE. 2017;12(7):e181754.

    Article  Google Scholar 

  24. Deitch JR, Starkey C, Walters SL, Moseley JB. Injury risk in professional basketball players: A comparison of Women’s National Basketball Association and National Basketball Association athletes. Am J Sports Med. 2006;34(7):1077–83.

    Article  Google Scholar 

  25. Nordenvall R, Bahmanyar S, Adami J, Stenros C, Wredmark T, Fellander-Tsai L. A population-based nationwide study of cruciate ligament injury in Sweden, 2001–2009: Incidence, treatment, and sex differences. Am J Sports Med. 2012;40(8):1808–13.

    Article  Google Scholar 

  26. Ito E, Iwamoto J, Azuma K, Matsumoto H. Sex-specific differences in injury types among basketball players. Open Access J Sports Med. 2015;6:1–6.

    PubMed  Google Scholar 

  27. Mountcastle SB, Posner M, Kragh JF Jr., Taylor DC. Gender differences in anterior cruciate ligament injury vary with activity: Epidemiology of anterior cruciate ligament injuries in a young, athletic population. Am J Sports Med. 2007;35(10):1635–42.

    Article  Google Scholar 

  28. Bere T, Florenes TW, Nordsletten L, Bahr R. Sex differences in the risk of injury in World Cup alpine skiers: A 6-year cohort study. Br J Sports Med. 2014;48(1):36–40.

    Article  Google Scholar 

Download references

Acknowledgements

The authors gratefully thank all donors who placed their bodies at disposal by last will and testament to the body donation program of this university. Without their gift anatomic research would not be possible.

Funding

None of the authors has a financial interest in any of the products or devices mentioned in this manuscript. This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Division of Plastic and Reconstructive Surgery, Department of Surgery, Wilhelminenspital Vienna, Montlearstraße 37, 1160, Vienna, Austria

    Martin F. Vierhapper MD

  2. Vienna, Austria

    Gabriela K. Muschitz MD, PhD

  3. Clinic for Facial Plastic Surgery, Marienhospital Stuttgart, Stuttgart, Germany

    Stefan Hacker MD

  4. Department of Trauma Surgery, AUVA trauma hospital Meidling Vienna, Medical University of Vienna, Kundratstraße 27, 1120, Vienna, Austria

    Sandra E. Boesmueller MD, PhD

  5. Center of Anatomy and Cell Biology, Department of Applied Anatomy, Medical University of Vienna, Währinger Straße 13, 1090, Vienna, Austria

    Michael Pretterklieber MD, PhD

  6. Laudongasse 25, 1080, Vienna, Austria

    Hugo B. Kitzinger MD, PhD

Authors
  1. Martin F. Vierhapper MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gabriela K. Muschitz MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Stefan Hacker MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sandra E. Boesmueller MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michael Pretterklieber MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hugo B. Kitzinger MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Martin F. Vierhapper MD.

Ethics declarations

Conflict of interest

M.F. Vierhapper, G.K. Muschitz, S. Hacker, S.E. Boesmueller, M. Pretterklieber, and H.B. Kitzinger declare that they have no competing interests.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This work was presented at the annual meeting of the Austrian society of plastic and reconstructive surgery in October 2016 in Innsbruck

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Vierhapper, M.F., Muschitz, G.K., Hacker, S. et al. Sexual dimorphism in the anatomy of the ulnar collateral thumb ligament. Wien Klin Wochenschr 131, 216–220 (2019). https://doi.org/10.1007/s00508-019-1483-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00508-019-1483-8

Keywords

Search

Navigation