[Local anaesthetic infiltration increases the accuracy of assessment of ulnar collateral igament injuries] described how Oberst anesthesia (in which 1–2 ml of lidocaine is injected in the MCP joint) increases the clinical accuracy from 28% to 98% after an average of one week after the initial trauma. June 2009;vol40:6:652-656. Grade 2: Ligaments are partially torn (less than 3mm), Grade 3: Ligaments are completely torn or more than 3mm, Grade 4: Failed immobilization and required surgery as did all of those with a Stener lesion, Skier’s thumb (UCL tear): is characterized by point tenderness and instability at the thumb MCP joint, while. [15] Gentle flexion and extension range of motion exercises can begin after about four weeks, with the patient continuing to wear the splint between therapy sessions. Read more, © Physiopedia 2020 | Physiopedia is a registered charity in the UK, no. Orthopaedic Surgery. Rupture of the ulnar collateral ligament of the thumb – a review. rare; ulnar collateral ligament. Wheeless' Textbook of Orthopaedics Online: This page was last edited on 25 October 2020, at 15:05. Skier’s Thumb (also known as “Gamekeeper’s Thumb”) is a very common and highly annoying sports injury. It is important to note that pain when examining can cause apprehension with subsequent tensing of surrounding muscles and can lead to a false negative. 2014;vol 33:6:384–389. Extension: Gently bend your wrist backward. [citation needed]. Photo courtesy H. Stevenson. It is important to note that this injury is not exclusive to skiers and can occur to anyone where there is an extreme valgus stress force applied to the thumb in abduction and extension. Skier's thumb describes an injury of the soft tissue that connects the bones of your thumb together. [28]. [9][11] The UCL prevents the thumb from pointing too far away from the hand. Game keepers thumb. Green DP, Hotchkiss RN, Pederson WC, eds. [35] Wrist sprains are graded according to severity: Wrist fracture: A broken wrist (wrist fracture) can involve the small bones in the wrist or the ends of the forearm bones. Physiopedia is not a substitute for professional advice or expert medical services from a qualified healthcare provider. EM in 5. [9], "Surgical Treatment of Acute Gamekeeper's Thumb", "Injuries to the Collateral Ligaments of the Metacarpophalangeal and Interphalangeal Joints: Sonographic Appearance: Sonography of Collateral Ligament Injuries in the Hand", "Injury to the Ulnar Collateral Ligament of the Thumb", Orthopedic Surgery for Gamekeeper's Thumb, https://en.wikipedia.org/w/index.php?title=Ulnar_collateral_ligament_injury_of_the_thumb&oldid=985364845, Articles with unsourced statements from October 2020, Creative Commons Attribution-ShareAlike License, Avulsion fractures of the ulnar base of the proximal phalanx of the thumb ( Gamekeeper's fracture ). [17], Figure 2B. [citation needed], The patient will often manifest a weakened ability to grasp objects or perform such tasks as tying shoes and tearing a piece of paper. [30] An injury that is not managed properly can lead to chronic instability of the MCPJ. Pain at the base of the thumb in the web space between thumb and index finger. 2006;73(5):827-834, Samora J.B. Outcomes After Injury to the Thumb Ulnar Collateral Ligament,, Clin J Sport Med. Post-operatively a cast, brace, or splint to partially immobilise the hand is mandatory due to the likelihood of long-term complications if left mobile and to avoid stiffness that may result from complete immobilisation. In medical terms, this soft tissue is called a ligament. How is Skier's/Gamekeeper's thumb treated? New York, NY: Churchill Livingstone. Any hard force on the thumb that pulls the thumb backward or to the side can damage or even completely tear this ligament. [41]. Pain was absent or mild in 99% of the cases. Ulnar collateral ligament injuries of the thumb: 10 years of surgical experience. Gamekeeper's thumb (also known as skier's thumb or UCL tear) is a type of injury to the ulnar collateral ligament (UCL) of the thumb. Do 2 sets of 15. [29] Indications for surgical treatment based on imaging include avulsion fractures with displacement of greater than 5 mm or any fracture involving 25% or more of the MCP joint surface . In severe cases where the ligament is completely torn, surgery is the only option. When there is abnormal movement like hyperabduction of the thumb or a sudden force on the thumb then the ligament can rupture (with or without an avulsion fracture). In the case of skier’s thumb (obviously the result of a skiing accident), the UCL is damaged when a sudden force is placed on the thumb. Skier's thumb, or gamekeeper's thumb, is when a ligament in your thumb is stretched or torn.