Gamekeeper's thumb

Gamekeeper's thumb, also known as skier's thumb, is a type of injury to the ulnar collateral ligament (UCL) of the thumb. The UCL is a band of tough, fibrous tissue that connects the bones of the thumb to the hand at the metacarpophalangeal (MCP) joint, which is located at the base of the thumb. This injury is characterized by pain, swelling, and decreased ability to grasp or pinch with the affected thumb.

Causes

Gamekeeper's thumb originally got its name from Scottish gamekeepers, particularly those involved in setting rabbit traps, who would frequently sustain this type of injury. In modern times, it is more commonly associated with skiing accidents, hence the alternate name "skier's thumb," where it occurs when the skier falls with an outstretched hand while holding a ski pole. However, it can result from any forceful abduction or hyperextension of the thumb.

Symptoms

The primary symptoms of Gamekeeper's thumb include:

• Pain at the base of the thumb in the web space between the thumb and index finger
• Swelling over the MCP joint
• Bruising or discoloration may be present
• Weakness or difficulty in grasping objects between the thumb and index finger

Diagnosis

Diagnosis of Gamekeeper's thumb typically involves a physical examination and medical history. The doctor may perform specific tests to assess the stability of the thumb's MCP joint. Imaging tests, such as X-rays, are often used to rule out fractures. In some cases, an MRI or ultrasound may be necessary to evaluate the extent of the ligament injury.

Treatment

Treatment for Gamekeeper's thumb depends on the severity of the injury. Mild injuries may be treated with splinting, ice, and anti-inflammatory medications to reduce pain and swelling. The thumb may need to be immobilized in a splint for several weeks to allow the ligament to heal. Physical therapy may also be recommended to restore strength and range of motion.

More severe injuries, particularly those involving a complete tear of the ligament or an associated fracture, may require surgical intervention. Surgery aims to repair or reconstruct the damaged ligament. Post-surgery, rehabilitation is crucial for regaining thumb function.

Prevention

Preventive measures for Gamekeeper's thumb include using proper technique and protective equipment when participating in activities that pose a risk of thumb injury. For skiers, selecting ski poles with straps that release easily during a fall can help reduce the risk.

See also

• Ligament injury
• Metacarpophalangeal joint
• Physical therapy