What is Gamekeeper’s Thumb?
Gamekeeper’s thumb (or Skier’s thumb) is a condition wherein the ulnar collateral ligament (UCL) of the thumb is torn at the point where the thumb joins the hand at the metacarpal phalangeal joint (MCP). It is usually an acute, specific injury that occurs after a sudden fall or trauma, but can also occur as the result of chronic weakening of the UCL over time as the result of repetitive motion.
What causes Gamekeeper’s Thumb?
The primary cause of Gamekeeper’s thumb is a fall on the open hand, where the thumb is violently pushed away from the index finger. This results in the tearing of the UCL and the displacement of the bone, usually. It is also not uncommon for the tendon to tear entirely, and this often results in a Stener lesion, which is caused when another tendon interposes itself between the UCL and the bones of the thumb, which makes it impossible for the tendon to heal properly.
What are symptoms of Gamekeeper’s Thumb?
Symptoms are dependent upon how severe the tear of the UCL is, but usually include pain, swelling, tenderness and bruising around the injury. As a result of the UCL tear, patients also have great difficulty forming pinch grasps, which are reliant on the UCL to function. Pain may increase in chronic case if the thumb or joint are jarred or irritated as traumatic arthritis may develop.
How to diagnose Gamekeeper’s Thumb.
An injury of this type should be seen by a doctor as soon as possible, at which point it will be determined whether or not the injury is simply a sprain or a greater injury. During clinical exam the stability of the joint will be tested. X-rays of the thumb will look for fractures. Additionally an MRI usually is ordered to ascertain the severity of the tear.
Non-surgical treatment of Gamekeeper’s Thumb.
If the injury is not severe enough to require surgery, a period of immobilization will be necessary to allow the strained ligament time to heal. Following 4-6 weeks of splinting, it is important that you begin a regimen of movement therapy and exercise in order to regain full mobility.
Surgical treatment of Gamekeeper’s Thumb.
If the tendon has been completely torn, or if a Stener lesion is present on MRI, surgery is the best possible method of treatment for Gamekeeper’s thumb. The doctor will proceed with surgery, which is minimally invasive, and may require the use of a pin to anchor the ligament to the bone. It is important to undergo surgery as soon as possible after the injury, if it is required, as the longer you wait, the less likely the joint will respond to the surgery as it may develop traumatic arthritis.
How can Dr. Knight help you with Gamekeeper’s Thumb?
Working in sports medicine, Dr. Knight is very familiar with this type of injury and is well versed in its treatment. Upon ascertaining the severity of your case, he will proceed in the manner most appropriate in order to bring your hand back to full use.
Thumb Ulnar Collateral Ligament (UCL) Injury Animation Video
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