the Impact of Partial Ligament Injury on Hand Function

My father severed the ulnar collateral ligament on the inner side of his wrist due to improper handling of equipment?

Hello, my father accidentally cut the ulnar collateral ligament on the inner side of his right wrist while using a utility knife improperly.
The doctor initially intended to locate and suture the ligament but was unable to find it, so only the skin was sutured, with just one stitch inside.
Before the suturing, the doctor asked if he felt any numbness, pain, or warmth when he clenched his fist, and my father confirmed that he did not.
The doctor mentioned that since the main ligament was not severed and he could still move his hand, there was no need to reconnect the collateral ligament.
I have a question: is it true that not reconnecting the collateral ligament will have minimal impact on hand function? My father often needs to exert force in his work, so I would like to inquire about the potential long-term effects.
Thank you for your patient response!

SU, 20~29 year old female. Ask Date: 2016/07/24

Dr. Yin Xinbei reply Rehabilitation

A utility knife is more likely to sever a tendon rather than a ligament, as ligaments are located deeper near the bones.
If a ligament were injured, the wound would be quite deep, and the tendon would likely be cut first.
The tendons on the inner side of the wrist are responsible for the flexion of the wrist and fingers.
If one of these tendons is severed, it will naturally affect hand strength.
If all five fingers can still grip tightly, it suggests that the flexor tendon of the wrist may be damaged.
There are two flexor tendons in the wrist; if the smaller one is severed, the impact on daily life may be minimal, but strength will be reduced.
It is recommended to have the original physician provide a diagnosis indicating which tendon is severed or to consult a rehabilitation specialist to assess which tendon is affected, in order to arrange subsequent rehabilitation or evaluate the need for further surgery.

Reply Date: 2016/07/24

More Info

The situation you described regarding your father's partial ligament injury raises important considerations about the function of the hand and the implications of such injuries. The ulnar collateral ligament (UCL) is a critical structure in the wrist that helps stabilize the joint, particularly during activities that require gripping or applying force. When this ligament is injured, the extent of the injury can significantly influence hand function, especially in individuals whose occupations or daily activities involve repetitive or forceful hand movements.

In your father's case, since the surgeon was unable to locate the ligament for repair and only sutured the skin, it suggests that the injury might not have been a complete tear of the main ligament. This is a positive sign, as partial tears can sometimes heal on their own, especially if the main stabilizing structures remain intact. The fact that your father could still grip without pain, numbness, or heat sensation indicates that the primary nerve and vascular structures are likely intact, which is crucial for hand function.

However, the ulnar collateral ligament plays a significant role in stabilizing the wrist during activities that involve gripping or applying force. If the ligament is partially torn or not functioning optimally, it can lead to instability in the wrist joint. This instability may not be immediately apparent, especially if your father is able to move his hand and wrist without pain. However, over time, he may experience increased discomfort, weakness, or a sense of instability, particularly during activities that require significant force or precision.

The impact of not repairing the collateral ligament can vary based on several factors, including the severity of the injury, the individual's activity level, and their overall hand strength. For someone like your father, who frequently uses his hands for work, the lack of proper stabilization could lead to compensatory movements that might strain other structures in the wrist or hand, potentially leading to further injuries or chronic pain.

In terms of rehabilitation, it would be beneficial for your father to engage in a structured physical therapy program. This program should focus on strengthening the muscles around the wrist, improving flexibility, and enhancing proprioception (the body's ability to sense movement and position). A physical therapist can provide tailored exercises that help restore function while minimizing the risk of aggravating the injury.

Additionally, it is essential to monitor for any signs of complications, such as persistent pain, swelling, or decreased range of motion. If these symptoms arise, it may warrant further evaluation by an orthopedic specialist. They may consider imaging studies, such as an MRI, to assess the integrity of the ligament and surrounding structures more thoroughly.

In summary, while the immediate impact of not repairing the collateral ligament may not seem significant, the long-term effects could be more pronounced, especially for someone who relies heavily on hand function for their work. Encouraging your father to follow up with a healthcare provider and consider rehabilitation will be crucial in ensuring he maintains optimal hand function and minimizes the risk of future complications.

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