Radial Collateral Ligament of the Thumb Injury

Other Names

• RCL Thumb Injury
• Thumb RCL

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Differential Diagnosis

• Fractures
  • Phalanx Fractures (Hand)
  • Metacarpal Fractures
    • Boxer's Fracture
    • Rolando Fracture
    • Bennett Fracture
• Dislocations
  • Metacarpophalangeal Joint Dislocation
  • Proximal Interphalangeal Joint Dislocation
  • Distal Interphalangeal Joint Dislocation
  • Carpometacarpal Joint Dislocation
• Tendinopathies
  • Extensor Tendon Injuries (Hand)
  • Central Slip Extensor Tendon Injury
  • Flexor Tendon Injuries (Hand)
  • Boutonniere Deformity
  • Swan Neck Deformity
  • Jersey Finger
  • Mallet Finger
  • Trigger Finger
  • De Quervains Tenosynovitis
  • Volar Plate Avulsion Injury
  • Sagittal Band Injury
• Ligament Injuries
  • Gamekeepers Thumb (UCL)
  • Radial Collateral Ligament of the Thumb Injury (RCL)
• Neuropathies
  • Wartenbergs Syndrome
  • Carpal Tunnel Syndrome
  • Guyon Canal Syndrome
• Arthropathies
  • Carpometacarpal Arthritis
  • Finger Arthritis
  • Rheumatoid Arthritis
• Nail Bed Injuries
  • Nail Bed Lacerations
  • Nail Bed Avulsions
  • Subungual Hematoma
  • Paronychia
  • Felon
• Pediatric Considerations
  • Proximal Phalanx Avulsion Fracture (Thumb)
  • Middle and Distal Phalanx Avulsion Fracture
• Other
  • Dupuytrens Contracture

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Clinical Features

• History
• Physical Exam: Physical Examination Hand
• Special Tests

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Classification

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The classification of MCP collateral ligament injuries is critical to the guidance of proper management. RCL and UCL injuries utilize the same three stage classification system as follows {1-4}:

• Grade 1: Incomplete tear of the RCL with only few torn fibers – tenderness to palpation and without laxity present on stressing examination
  
• Grade 2: Incomplete tear of the RCL with a greater number of torn fibers present – increased tenderness to palpation at the radial aspect of the MCP, more prominent swelling and the presence of laxity on stressing but with a definitive end point.
  
• Grade 3: Complete tear of the RCL – tenderness to palpation, swelling and prominent instability/laxity with no end point on stressing examination

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See Also

• Hand and Wrist Anatomy (Main)
• Finger Pain (Main)
• Hand Pain (Main)
• Physical Examination Hand

External

• Sports Med Review Hand Pain: https://www.sportsmedreview.com/by-joint/hand/

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References

1. LM;, Rozmaryn. “The Collateral Ligament of the Digits of the Hand: Anatomy, Physiology, Biomechanics, Injury, and Treatment.” The Journal of Hand Surgery, U.S. National Library of Medicine, 2017, pubmed.ncbi.nlm.nih.gov/29101974/.
2. Netscher, David T, et al. “Finger Injuries in Ball Sports.” Hand Clinics, U.S. National Library of Medicine, Feb. 2017, www.ncbi.nlm.nih.gov/pubmed/27886829.
3. RG;, Daley D;Geary M;Gaston. “Thumb Metacarpophalangeal Ulnar and Radial Collateral Ligament Injuries.” Clinics in Sports Medicine, U.S. National Library of Medicine, 2020, pubmed.ncbi.nlm.nih.gov/32115093/.
4. SK;, Edelstein DM;Kardashian G;Lee. “Radial Collateral Ligament Injuries of the Thumb.” The Journal of Hand Surgery, U.S. National Library of Medicine, 2008, pubmed.ncbi.nlm.nih.gov/18590860/.