A Surgical Approach to a Thumb Metacarpophalangeal Joint Ulnar Collateral Ligament Injury without Dividing the Adductor Aponeurosis

An injury to the ulnar collateral ligament (UCL) of the metacarpophalangeal joint (MCPJ) of the thumb is a common injury, widely referred to as a skier's thumb. The rupture usually occurs at the distal insertion. In the classical technique, the adductor aponeurosis is divided to access the torn UCL and the MCPJ and repaired after ligament repair/reinsertion. We describe a surgical approach to the UCL that does not require division of the adductor aponeurosis. <b>Level of Evidence:</b> Level V (Therapeutic).