Gamekeepers thumb

An avulsion fracture at the ulnar base of the first proximal phalange, linked to the ulnar collateral ligament of the metatarsophalangeal joint.

Anatomy of gamekeepers thumb

• Gamekeepers thumb is an insufficiency of the ulnar collateral ligament (UCL) of the metatarsophalangeal (MCP) joint of the thumb

Mechanism of Injury• Skiing accidents are the most common

causes of injuring this ligament. Injuries of this ligament make up 8-10% of all skiing accidents.

• A fall on an outstretched hand with a ski pole in the palm of your hand creates the force to stress the thumb and stretch or tear the ligament

• Usually, the injury is not created by a regular fall

• May be caused in automobile accidents when the thumb is draped over the steering wheel

Treatment• Within the first few weeks of

injury, surgery is usually most effective

• If the ligament is torn from the bone, then the torn end will be sutured down itself.

• If the injury is older then a direct repair is not possible. One of the muscles at the base of the thumb will have to be advanced to compensate for the torn ligament.

• If you have no treatment, you most likely will develop arthritis

Recovery• Flexion• Extension• Side to side• Thumb strengthening:• Finger spring: Place a large

rubber band around the outside of your thumb and the rest of your fingers. Open your fingers to stretch the rubber band. Do 3 sets of 10

• Grip strengthening• Wrist flexion• Wrist extension

RECOVERY TIME3-4 months