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(Skier’s Thumb; Gamekeeper’s Thumb)

Definition

An ulnar collateral ligament (UCL) sprain is an injury to the ligament of the first thumb joint. A ligament is a band of tissue that connects bone to bone. A sprain is tearing of a ligament.

Causes

This sprain is caused by trauma to the ligament. This can happen from a fall or sports injury. It can also be from repeated stress on the UCL.

Risk Factors

Things that put you at higher risk for this sprain are:

  • Sports, such as skiing, football, biking, and soccer
  • Falling

Symptoms

You may have:

  • Pain
  • Bruising
  • Swelling
  • Weakness when you hold or squeeze things
  • Poor range of motion

Diagnosis

You will be asked about your symptoms, health history, and how the injury happened. A physical exam will be done. It will focus on your thumb. The diagnosis can be made based on the exam and what you were doing at the time you were hurt.

Images may be done to find out how much harm was done. This can be done with:

  • X-ray
  • MRI or CT scan
  • Arthrography using contrast material to view the joint
Bones in the Hand
IMAGE
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Treatment

Talk with your doctor about the best treatment plan for you. It will be based on the severity of your injury. Some choices are:

Supportive Care

A cast or splint may be needed to keep the thumb from moving. This will help protect, support, and keep the thumb stable while it heals.

Exercises may be needed to help regain strength and motion.

A cast or splint may be needed to keep the thumb from moving. This will help protect, support, and keep the thumb stable while it heals.

Exercises may be needed to help regain strength and motion.

Surgery

Surgery may be needed for a fracture, severe sprain, or complete tear of the ligament.

Surgery may be needed for a fracture, severe sprain, or complete tear of the ligament.

Prevention

You can lower your risk of getting a UCL sprain by learning and using correct technique in sports. Some UCL sprains cannot be prevented.

RESOURCES

Family Doctor—American Academy of Family Physicians   http://www.familydoctor.org 

Ortho Info—American Academy of Orthopaedic Surgeons   http://www.orthoinfo.org 

CANADIAN RESOURCES

Canadian Orthopaedic Foundation  http://www.canorth.org 

Health Canada  https://www.canada.ca 

References

Skier’s thumb. British Society for Surgery of the Hand website. Available at: http://www.bssh.ac.uk/patients/conditions/32/skiers%5Fthumb. Accessed June 19, 2019.

Sprained thumb. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=a00022. Updated June 2018. Accessed June 19, 2019.

Tang P. Collateral ligament injuries of the thumb metacarpophalangeal joint. J Am Acad Orthop Surg. 2011 May;19(5):287-296.

Ulnar collateral ligament injury of the thumb. American Society of Hand Therapists website. Available at: https://www.asht.org/sites/default/files/docs/2016/UCL%20Injury%20of%20the%20Thumb%202016.pdf. Accessed June 19, 2019.

Ulnar collateral ligament sprain of thumb. EBSCO DynaMed website. Available at:  https://www.dynamed.com/topics/dmp~AN~T115627/Ulnar-collateral-ligament-sprain-of-thumb . Updated June 7, 2017. Accessed June 19, 2019.

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