Grade 1 to 2 Thumb Ulnar Collateral Ligament Injuries in Athletes Requiring Surgery After Stress Testing

CASE: A 19-year-old baseball player and a 16-year-old golfer presented with persistent thumb pain and instability after prolonged nonoperative management and magnetic resonance imaging (MRIs) showing grade 1 to 2 thumb ulnar collateral ligament (UCL) injuries (typically treated nonoperatively). Both underwent fluoroscopic stress examinations showing significant UCL instability, opted to undergo operative repair, and were able to return to play. CONCLUSION: A fluoroscopic stress examination should be performed in patients with low-grade injuries reported on MRI but with continued symptoms, especially in young athletes. If the stress examination shows significant asymmetric widening and the patient is unable to grip properly, surgery may be indicated.