Hand injuries: Stener lesion: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Hand injuries: Stener lesion

Sample item

Examination of a thumb after a ski-pole injury shows complete ulnar collateral ligament rupture with a tender palpable lump proximal to the MCP joint. Ultrasound shows the ligament lying superficial to the adductor aponeurosis. What is the implication?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. A Stener lesion, so the ligament cannot heal and surgical repair is needed

In a Stener lesion the torn ligament is displaced proximally and the adductor pollicis aponeurosis lies between it and its bony insertion. The ligament cannot reattach, so conservative treatment fails and surgical repair is required. A palpable tender mass at the metacarpal head is the clue.

Option by option

  • A. A Bennett fracture, so closed reduction and percutaneous pinning is needed

    A Bennett fracture is an intra-articular fracture of the first metacarpal base and not a ligament interposition.

  • B. A trigger thumb, so a steroid injection is the treatment

    Trigger thumb is a flexor tendon sheath problem and does not follow an acute injury.

  • C. A Stener lesion, so the ligament cannot heal and surgical repair is needed (correct)

    Correct. Interposed adductor aponeurosis prevents healing, so surgery is indicated.

  • D. A sprain, so a thumb spica cast for 3 weeks is sufficient

    A simple partial sprain would heal in a cast, but a displaced complete tear with interposition would not.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is C, A Stener lesion, so the ligament cannot heal and surgical repair is needed. In a Stener lesion the torn ligament is displaced proximally and the adductor pollicis aponeurosis lies between it and its bony insertion.

Why is "A Bennett fracture, so closed reduction and percutaneous pinning is n…" not the answer?

A Bennett fracture is an intra-articular fracture of the first metacarpal base and not a ligament interposition.

Why is "A trigger thumb, so a steroid injection is the treatment" not the answer?

Trigger thumb is a flexor tendon sheath problem and does not follow an acute injury.

Why is "A sprain, so a thumb spica cast for 3 weeks is sufficient" not the answer?

A simple partial sprain would heal in a cast, but a displaced complete tear with interposition would not.

What concept does this question test?

It tests Hand injuries: Stener lesion in Orthopaedics. The ligament cannot reattach, so conservative treatment fails and surgical repair is required. A palpable tender mass at the metacarpal head is the clue.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hand injuries: Stener lesion?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.