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Dr Shaan Patel, Orthopedic Hand, Wrist, Elbow and Shoulder Surgeon, Mount Juliet,Lebanon, TN // Hand/Wrist // Hand/Wrist Conditions // Thumb UCL Injury
Thumb UCL Injury pic

What is a Thumb UCL Injury?

A thumb UCL (ulnar collateral ligament) injury, often referred to as "skier's thumb" or "gamekeeper's thumb," involves a tear or sprain of the ligament on the inner side of the joint where the thumb meets the palm. The injury occurs when the ligament is stretched beyond its limits. This usually happens when a strong force bends the thumb backward, away from the palm of the hand. This ligament is crucial for stabilizing the thumb's base, particularly during pinching or gripping activities.

Causes of Thumb UCL Injury

Thumb UCL injury typically occurs when falling on an outstretched hand or during sports activities. A thumb UCL injury is most common in these sports:

  • Basketball
  • Skiing
  • Snowboarding
  • Baseball
  • Football
  • Racket sports (e.g. tennis or racket ball)

Symptoms of Thumb UCL Injury

Symptoms of thumb UCL injury include:

  • Pain and swelling: Around the base of the thumb.
  • Weakness: Difficulty gripping or pinching objects.
  • Instability: The thumb feels unstable or loose.
  • Bruising: Possible bruising around the injured area.

Diagnosis of Thumb UCL Injury

Diagnosis of thumb UCL injury may involve the following:

  • Physical examination: The doctor will check for tenderness, swelling, and stability of the thumb.
  • X-rays: To rule out fractures.
  • MRI or ultrasound: To assess the extent of ligament damage.

Treatment for Thumb UCL Injury

Non-Surgical Treatment

  • Rest: Avoid activities that strain the thumb.
  • Ice: Apply ice to reduce swelling.
  • Immobilization: Use a thumb splint or cast to keep the thumb in a stable position and allow healing.
  • Physical Therapy: Exercises to strengthen the thumb and improve range of motion once initial healing has occurred.

Surgical Treatment:

  • Indications: Complete tears, significant instability, or if non-surgical treatment fails.
  • Procedure: The torn ligament is repaired, often with sutures or by using a graft from another tendon.
  • Rehabilitation: Post-surgery, the thumb is immobilized, followed by physical therapy to regain strength and flexibility.

Recovery:

  • Non-Surgical: Typically, 6-8 weeks with immobilization followed by physical therapy.
  • Surgical: May take several months, including a period of immobilization and gradual physical therapy.

Prevention:

  • Protective gear: Using thumb braces or guards during high-risk activities.
  • Proper technique: Ensuring correct techniques in sports and repetitive tasks to minimize stress on the thumb.