Thumb MP joint ligament injury

May 22nd, 2007

The most common cause of a ligament injury to the thumb metacarpophalangeal (MP) joint is a skiing injury--thus the name (skiier's thumb. Historically Gamekeeper's were reported to experience attrition of the ulnar collateral ligament from using the hand and thumb during specific job activities---thus the name "gamekeeper's thumb". In 2005 my own wife had her hand in the pole strap--a definite no no--- and sustained the injury to the "ulnar collateral" ligament. The good news is that if it is only a partial tear, effective treatment can be provided with a cast for 6-8 weeks. The bad news is that complete tears require surgery to reattach the ligament.

The thumb MP radial collateral ligament can be torn as well--and both ligaments can avulse with a small piece of bone as well. Xray will show this. If there is a piece of bone, fixation may utilize a smal pin or screw.

Postoperatively, a splint or cast will be necessary for 6 weeks or so, and full recovery may take 3-6 months.

Related Photos:

Preoperative laxity, consistent with either complete tear of the ulnar collateral ligament or displaced avulsion fracture

Typical surgical incision

Preoperative xray shows displaced avulsion fracture

Fracture fixation has been performed with a small screw