The degree of instability was compared with the contralateral hand. The clinical diagnosis of MCP collateral ligament tear was based upon patient history and physical exam that demonstrated pain or instability of the joint when held in 60° of flexion and stressed. Where indicated in the MRI report, the strength of the MRI field (open, 1.5 or 3 T) was noted. Results of the preoperative imaging studies were based on the interpretation of the attending radiologist's report. The preoperative imaging studies and intraoperative findings were compared. These patients all underwent standard, noncontrast MRI examination preoperatively. Two patients who did not undergo preoperative MR imaging were excluded, leaving 20 patients with 22 ligament injuries for review. Patients with avulsion fractures were not included in the study. We retrospectively reviewed 22 consecutive patients, with 24 closed traumatic lesser digit MCP collateral ligament ruptures that were treated surgically. The present study was performed using the data that was obtained for an Institutional Review Board approved study on surgical outcomes following lesser digit collateral ligament repair. The purpose of the present study is to assess the accuracy of MRI for diagnosing collateral ligament tears at the MPJ of the fingers in a cohort of surgically treated patients. As a result, the use of ancillary imaging studies may have a greater role in the diagnosis of lesser digit MPJ collateral ligament injury. The neighboring digits can preclude an accurate measure of laxity, and there can be some degree of preexisting “normal” laxity that may be greater than that of the collateral ligaments of the thumb. In part, this may be due to the increased difficulty in assessing instability of the lesser digit MPJs. In the fingers, the degree of normal versus pathologic collateral ligament laxity is not well documented, and the indications for and results of surgical repair are less well established. Most reports of this type of injury have focused on the radial collateral ligament (RCL) of the index finger. Injuries to the collateral ligaments of the metacarpophalangeal (MCP) joints of the fingers are less common than their counterparts in the thumb metacarpophalangeal joint (MPJ).
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