GAMEKEEPER'S THUMB (UCL TEAR)
Gamekeeper’s Thumb, also known as Skier’s Thumb, results from acute or chronic injury of the ulnar collateral ligament (UCL). Bones are connected to one another by fibrous, strong connective fibres called ligaments.The primary ligament that helps stabilize the metacarpophalangeal (MCP) joint is the UCL, which is situated on the inside of the thumb. The UCL may be strained or torn (partially or completely), which weakens the thumb's ability to grasp or pinch.
HAND & WRIST ANATOMY
Symptoms of Gamekeeper’s thumb or a UCL tear in the thumb may include:
• Joint pain
• Misaligned thumb
• Reduced range of motion
• Weakened grip
• Instability and pain with range of motion
Gamekeeper’s Thumb can be caused by acute injury or chronic overuse.
• Activities that require a tight grip, such as tennis, golf or skiing
• Fall on out stretched hand
• High-impact sports like rugby or football
• Motor vehicle accident
Nonsurgical treatments may be sufficient to reduce swelling and stabilize the joint as the ligament heals.
The most common conservative treatments include:
• RICE (Rest, ice, compression, elevation)
• Rest and immobilization
• Anti-inflammatory medications such as NSAID medications and topical agents
After the splint is removed hand therapy or strength exercise is recommended.
If there is a complete tear of the ligament, surgery will be required to repair the ligament. Delay in obtaining surgical intervention can increase complications and reduce the likelihood of full return of function. Surgical repair of the UCL can be performed on an outpatient basis using a minimally invasive approach. The ligament is anchored back to the bone using pins or sutures. The thumb is then placed in a cast or splint to protect the repair.
Eventually hand therapy is used to restore function and range of motion to the thumb.
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