Ulnar collateral ligament (UCL) injury is a common hand injury, with significant morbidity particularly if undiagnosed or treated late. This common sports related injury (e.g. 9.5% of all skiing injuries) has an ever increasing prevalence. Specific imaging investigations may be required as an adjunct to clinical examination to assess the degree of instability and injury to the UCL. These injuries are often misdiagnosed in the emergency department and present late for specialist treatment. Ideally, acute tears (within 2 weeks) are best treated with cast immobilisation or primary repair of the ligament. With chronic instability at the MCP joint due to UCL laxity, dynamic or static ligament reconstruction using free tendon grafts are the best available options. This paper reports the results of a literature review and reports history, treatment and controversies in UCL management.
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