How is Skier’s or Gamekeeper’s Thumb Treated?
- Ice should be applied to reduce swelling for about 20 minutes every hour for the first 24 to 48 hours
- Acetaminophen or ibuprofen may be taken to reduce pain
- Splint or cast or restrict movements of the thumb as much as possible to lessen the pain
What is gamekeeper’s Thumb and how is it treated?
Gamekeeper’s thumb can normally be treated by resting and icing the thumb joint and wearing a protective cast for a few weeks. In the case of severe damage or a tear, an individual may need to undergo surgery to ensure a full recovery. Most cases of Gamekeeper’s thumb result from acute, rather than chronic, pressure on the joint.
What are the symptoms of gamekeeper’s thumb?
Pain at the base of the thumb is the most obvious and common symptom, acocmpaneid by swelling and weakness, and loss of the ability to pinch the thumb and forefinger together. In more severe cases, pain from the thumb may be referred to the wrist, but this is not necessarily a diagnostic feature. How can you get gamekeeper’s thumb?
How do you treat a torn UCL in the thumb?
Closed treatment. Nonoperative treatment can be considered for partial tears (grade I or grade II) of the UCL, which usually involve an isolated rupture of the proper collateral portion of the ligament. This may be treated with immobilization in a thumb spica-type cast for 4 weeks.
What is the initial treatment for a thumb fracture?
Initial treatment begins with icing, NSAID’s (non-steroidal anti-inflammatory drugs) to reduce pain and inflammation, and elevation of the hand to minimize swelling. Splints that stabilize and immobilize the thumb and/or wrist are required to facilitate healing and are generally worn for 4 to 6 weeks to allow adequate healing to take place.
What causes gamekeeper's thumb?
The gamekeeper's thumb injury may be caused by a valgus stress of any kind to the thumb. The most common history is a fall onto an outstretched arm with an abducted thumb. This commonly occurs in skiers with a ski pole in the hand, which prevents adduction of the thumb when the skier falls.
How do you know if you have gamekeeper's thumb?
You should be able to easily identify the symptoms of gamekeeper's thumb, which include:Pain and swelling at the base of the thumb.Difficulty grasping, pinching, or throwing objects.Unstable thumb at its base.Bruising at the base of the thumb.
How common is gamekeeper's thumb?
Gamekeeper's thumb, or skier's thumb, may constitute up to 50% of hand injuries in skiers. It may also be seen in patients with rheumatoid arthritis, those who have been in a motor vehicle accident, and athletes of other sports with injuries resulting from a fall onto an outstretched hand with an abducted thumb.
How do I get rid of skier's thumb?
Skier's Thumb Treatment Self-Care at HomeApply ice to the thumb for 35 minutes at a time, up to 4 times per day. ... Avoid movement of the thumb as much as possible. ... Take acetaminophen for pain relief or ibuprofen for anti-inflammatory action.More items...•
What is another name for gamekeeper's thumb?
Gamekeeper's thumb (also known as skier's thumb or UCL tear) is a type of injury to the ulnar collateral ligament (UCL) of the thumb.
Can a torn thumb ligament heal itself?
A torn ligament cannot fully heal itself. Surgery for the thumb collateral ligaments is usually done as an outpatient procedure, meaning you will probably go home the same day as the surgery.
Where does gamekeeper's thumb occur?
Gamekeeper's thumb is a condition that occurs when the inner ligament at the base of the thumb (the ulnar collateral ligament) is injured due to overuse or trauma. When sudden injury is the cause, the condition is usually called Skier's thumb.
How long does thumb ligament surgery take?
With traditional surgery, the ligament is sutured, and the thumb is immobilized in a cast for four to six weeks. "Athletes particularly dislike being in casts, and on top of that they can't return to play for sometimes up to 10-12 weeks," Shin notes. Internal brace augmentation cuts that time in half or less.
How do I strengthen my thumb ligaments?
Thumb IP flexionPlace your forearm and hand on a table. Your problem thumb should point up.With your other hand, hold your thumb steady just below the joint nearest your thumbnail.Bend the tip of your thumb down. Then straighten it.Repeat 8 to 12 times.Do this exercise several times a day.
Is skier's thumb serious?
Skier's thumb is an injury to the ulnar collateral ligament (UCL) of the thumb metacarpophalangeal joint (MCPJ) which has a serious risk of disabling chronic instability if not treated adequately. The lesion most often occurs in skiers when the ski pole forces the thumb to deviate radially.
Does a torn thumb ligament require surgery?
If your ligament is severely stretched or torn, or if nearby tissues and bone are also injured, your injury may not heal correctly on its own. You may need surgery. This can help the ligament heal and restore movement to and full use of your thumb.
How long does it take to recover from skiers thumb?
Activity. At some point as you recover, your provider will ask you to begin exercises to regain movement and strength in your thumb. This may be as soon as 3 weeks or as long 8 weeks after your injury. When you restart an activity after a sprain, build up slowly.
What is a gamekeeper's thumb?
The term Gamekeeper’s Thumb is used when referring to an ulnar collateral injury caused by repetitive stress on the thumb during such activities as using a wrench, twisting electrical cords or wringing out heavy cloths. The term Skier’s Thumb is commonly used when there is an acute, forceful abduction of the thumb as when a skier falls without ...
What splints are good for thumb?
Wearing a durable, comfortable splint such as the ThumSaver MP , the Fix Comfort Thumb Brace or the 3pp Ez FIT ThumSpica Spl int reduces stress on the thumb, gives the UCL time to heal, and helps to prevent further injury.
How long does it take for a thumb to heal from a splint?
Splints that stabilize and immobilize the thumb and/or wrist are required to facilitate healing and are generally worn for 4 to 6 weeks to allow adequate healing to take place.
How much UCL healing can be done with hand therapy?
With careful adherence to a splinting and therapy program, over 90% UCL injuries will heal.
What to do if no degenerative changes are present at the MCP joint?
If no degenerative changes are present at the MCP joint, consider a ligament reconstruction. A free tendon, usually the palmaris longus, can be woven through the metacarpal neck and the base of the proximal phalanx. If arthritis is present or if the patient is a manual laborer, consider an arthrodesis of the MCP joint.
How to repair a UCL tear?
See the list below: 1 Delayed repair of the UCL#N#Complete ruptures of the UCL require surgical intervention for repair within the first 3 weeks of the injury (preferably in the first week while the anatomic position is maintained).#N#Complete tears that are repaired after 3 weeks have an increased incidence of weakness and pain on pinch grasp. An associated increase in MCP joint arthritis is noted in the long term. 2 Closed treatment of a completely torn UCL#N#A 50% failure rate is reported with complete tears that are treated with bracing and early motion. If a patient is unable to tolerate or refuses surgery, then bracing is the treatment of choice. A thumb spica splint or functional brace can be attempted, but it must be understood that full stability of the thumb may not occur.#N#Soft-tissue interposition, which is caused by the adductor aponeurosis holding the torn UCL in a displaced position, prevents healing. Surgical correction is necessary to reconstruct the UCL and allow healing.#N#ROM is limited in the thumb at the MCP joint if the joint is immobilized longer than 4 weeks.
How long does ROM last in thumb?
ROM is limited in the thumb at the MCP joint if the joint is immobilized longer than 4 weeks.
How long does it take to treat a proximal avulsion fracture?
For small, nondisplaced avulsion fractures of the proximal phalanx that are found to be stable on stress testing, nonoperative treatment by a spica-type cast for 4 weeks can be completed with good results.
Can you use a brace for a UCL tear?
Nonoperative treatment can also be considered in patients that either refuse surgery or who are too infirm to tolerate an operative procedure despite a complete UCL tear. In these patients a functional brace or well-molded spica splint can be applied, [ 12, 13] but it must be understood by the patient that complete healing of the UCL is not expected if the tear was complete.
How to treat Gamekeeper's thumb?
Chronic overuse of the thumb joint can also lead to UCL damage over a period of time. Gamekeeper’s thumb can normally be treated by resting and icing the thumb joint and wearing a protective cast for a few weeks. In the case of severe damage or a tear, an individual may need to undergo surgery to ensure a full recovery. Most cases of Gamekeeper’s thumb result from acute, rather than chronic, pressure on the joint. A person might try to catchy him or herself when falling, placing excessive force on the thumb. Gamekeeper’s thumb is also called Skier’s thumb, as a falling skier can land with his or her thumb awkwardly wrapped around a ski pole. Regardless of the cause, most people who suffer Gamekeeper’s thumb injuries experience acute pain, swelling, and weakness in the thumb and hand.
How to prepare for a return to sports after a gamekeeper's thumb injury?
An important component of preparing for a return to sports after a Gamekeeper’s thumb injury is preparing the arm to properly withstand the stress placed on it during throwing or other overhead motions. Your therapist will work with you to establish and implement a progressive program to prepare you for a return to practice and competition.
What is a splint for a broken thumb?
As mentioned earlier, splinting and casting is appropriate for injured thumbs if the ligament is not loose or is only very slightly loose – these are known as partial tears, that is, Grade 1 or Grade 2 tears of the thumb. These tears usually involve an isolated rupture of the proper collateral ligament. Splinting or casting is also appropriate when there is a fracture, so long as the fragment of bone is displaced only a millimeter or two. The splint or cast should immobilize the thumb for 4 consecutive weeks – with appropriate treatment, good to excellent results can be expected in circa 90% of injuries.
What is a stener tear?
Stener lesions – A complete tear of the UCL forces the ligament out of position and traps it between the thumb muscles and bone. This is a serious complication of thumb UCL injuries.
How to diagnose a UCL injury?
The surgeon may order further tests, such as magnetic resonance imaging (MRI) or magnetic resonance arthrogram (MRA), to confirm the diagnosis and to rule out other possible damage. Your physiotherapist can additionally help improve your strength and range of motion following a UCL injury. Your therapist also will work with you before and after any necessary surgery and can help identify other issues that may have contributed to your injuries, such as range of motion and strength deficits, or improper mechanics. Your physiotherapist will also help you:
What is the best pain reliever for a sprain?
Medication – Over-the-counter pain relievers like ibuprofen or acetaminophen can help control pain associated with the injury.
What is the least severe UCL tear?
Grade 1 – This is the least severe level of UCL tear. Stretching of the ligament may cause pain, but there is no observed tearing.
What is a Gamekeeper's thumb?
Gamekeeper’s Thumb, also called Skier’s Thumb, is an injury to the thumb on the little finger side, at the second joint from the thumbnail (MP joint). The ligament can be either torn itself, or the ligament can be torn from the bone, usually pulling a small fragment of bone off with it, as illustrated below.
Why is the thumb important?
Because the stability of the thumb is important for holding things between the thumb and the index finger, treatment is directed toward optimizing the healing of the ligament to restore its full function. Gamekeeper’s thumb is a common injury. The incidence is increased in skiers, but it does not depend on the type of ski pole used.
What is a partial tear of the thumb called?
These are called partial tears, that is, grade I or grade II tears, of the UCL. These tears usually involve an isolated rupture of the proper collateral ligament.
When is surgery needed for a Stener lesion?
Surgery is needed when there is too much looseness of the ligament (it is probably ruptured and the Stener lesion will prevent it from healing) or if there is a fracture and the bone fragment is displaced.
What is the muscle on the index finger called?
The muscle on the index finger side of the thumb (adductor) has an expansion called the aponeurosis, which usually gets stuck between the ruptured ligament and its site of insertion at the base of the proximal phalanx, preventing the ligament ends from touching. This is called a Stener lesion and prevents the ligament from healing back together. ...
Where is the broken fragment on the thumb?
This is a view of the thumb from the top, looking straight down on the thumbnail. Note the broken fragment of bone from the middle phalanx. (Note: this x-ray has been modified to remove the sesamoid bones, which can be confused with fracture fragments.)
Can you see a fractured thumb?
This is a view of the thumb from the side. You cannot see the fracture fragment, since it is in the middle of the bone on this view. What you can see is that the joint is not parallel: the bones are closer to the right than to the left. (Again, the sesamoids have been removed.)