235:
262:) occurs, the adequate healing of the tear is prevented altogether. For a Stener lesion to occur, a complete tear of the ulnar collateral ligament must be present. However, the Stener lesion can occur even in the absence of a tear of the accessory collateral ligament or volar plate. The Stener lesion is present in more than 80% of complete ruptures of the UCL of the thumb.
668:
266:
lesion), or simply a complete rupture of the UCL with anatomic or near-anatomic position. Radiographs are helpful in determining the possible presence of an avulsion fracture of the proximal phalanx insertion site of the ulnar collateral ligament. Stress examination, or one done under fluoroscopic guidance, can help determine the integrity of the ligament.
285:
CS Campbell, an orthopedic surgeon, originally coined the term gamekeeper's thumb in 1955, after he observed this condition in a series of 24 Scottish gamekeepers. The injury appeared to occur as a result of the particular manner in which they killed small animals such as rabbits; the animals were
137:
of gamekeeper's thumb are instability of the MCP joint of the thumb, accompanied by pain and weakness of the pinch grasp. The severity of the symptoms is related to the extent of the initial tear of the UCL (in the case of skier's thumb), or how long the injury has been allowed to progress (in the
217:
of the proximal phalanx of the thumb) is seen in a wide variety of other athletic endeavors. The most common mechanism of injury appears to be when a person extends the arm in an attempt to block a fall. The stress resulting from falling onto an abducted thumb produces a valgus force on the MCP
265:
When approaching this type of injury, the physician must first determine whether there is an incomplete rupture (or sprain) of the UCL, or a complete rupture. If the UCL is completely disrupted, the physician must then determine whether there is interposition of the adductor aponeurosis (Stener
246:
The ulnar collateral ligament is an important stabilizer of the thumb. Thumb instability resulting from disruption of the UCL profoundly impairs the overall function of the involved hand. Because of this, it is critical that these injuries receive appropriate attention and treatment.
156:
The patient will often manifest a weakened ability to grasp objects or perform such tasks as tying shoes and tearing a piece of paper. Other complaints include intense pain experienced upon catching the thumb on an object, such as when reaching into a pants pocket.
619:
48:
225:
In a recent study, 49% of UCL disruptions of the thumb were caused by a fall onto an outstretched hand. Sports injuries accounted for most of the remaining injuries, with only 2.4% acquired as a result of skiing injuries.
297:
Others have noted that
Scottish fowl or game hunters would develop this type of injury after carrying their game home in a leather thong, which they would attach to their thumb and drape over their shoulder.
273:
or a modified wrist splint and allowing the ligament to heal. However, near total or total tears of the UCL may require surgery to achieve a satisfactory repair, especially if accompanied by a
706:
206:
Gamekeeper's thumb is more difficult to treat because the UCL has lengthened and become thinner as a result of repeated injury. It is moderately painful compared to similar injuries.
672:
384:"Injuries to the Collateral Ligaments of the Metacarpophalangeal and Interphalangeal Joints: Sonographic Appearance: Sonography of Collateral Ligament Injuries in the Hand"
699:
185:
condition which has developed as a result of repeated episodes of lower-grade hyperabduction over a period of time. There are four types of Skier's thumb injury:
286:
placed on the ground, and their necks were broken as the gamekeeper exerted downward pressure with the thumb and index finger. This maneuver would place a
1060:
692:
894:
119:
89:
294:
metacarpophalangeal (MCP) joint. Over time, this would lead to insufficiency of the ulnar collateral ligament (UCL) of the thumb.
941:
490:
Chuter GS, Muwanga CL, Irwin LR (June 2009). "Ulnar collateral ligament injuries of the thumb: 10 years of surgical experience".
202:
of adductor pollicis, thus preventing the healing of proximal and distal segments of UCL. This condition is called Stener lesion.
153:, and especially over the MCP joint of the thumb. Physical examination demonstrates instability of the MCP joint of the thumb.
173:(UCL) of the thumb. The chief difference between these two conditions is that skier's thumb is generally considered to be an
301:
The term skier's thumb is derived from the fact that skiers often acquire this type of injury by falling against a planted
97:
234:
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may be interposed between the bones of the MCP joint and the torn ligament. When this condition (referred to as a
1065:
178:
255:
1030:
1025:
798:
306:
291:
214:
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Gamekeeper's thumb and skier's thumb are two similar conditions, both of which involve insufficiency of the
122:). It also occurs among people who sustain a fall onto an outstretched hand while holding a rod, frequently
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Full-thickness tear of the middle part of the UCL with the proximal fragment displaced superficial to the
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318:
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792:
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A post-operative photo of repair of a complete rupture of the ulnar collateral ligament. Note the
55:
Avulsion fractures of the ulnar base of the proximal phalanx of the thumb ( Gamekeeper's fracture )
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761:
684:
269:
Most gamekeeper's thumb partial injuries are treated by simply immobilizing the joint in a thumb
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Avulsion of distal UCL causing the pulling off of a bone chip off the proximal phalanx base.
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150:
108:
679:
931:
818:
628:
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17:
96:. The UCL may be merely stretched, or it may be torn from its insertion site into the
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100:
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181:(MCP) joint of the thumb, whereas gamekeeper's thumb typically refers to a
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Draghi, Ferdinando; Gitto, Salvatore; Bianchi, Stefano (September 2018).
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condition acquired after a fall or similar abduction injury to the
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Tsiouri, Chrysi; Hayton, Michael J; Baratz, Mark (2008).
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of the thumb. This condition is commonly observed among
435:"Injury to the Ulnar Collateral Ligament of the Thumb"
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990:
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748:
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548:Campbell CS (February 1955). "Gamekeeper's thumb".
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37:
32:
213:, this injury (resulting from forced abduction or
195:Full-thickness tear of the middle part of the UCL
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673:Ulnar collateral ligament injury of the thumb
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8:
678:Wheeless' Textbook of Orthopaedics Online:
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46:
29:
584:Orthopedic Surgery for Gamekeeper's Thumb
466:
409:
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335:
525:Jonathan Cluett, MD (March 19, 2016).
250:In most cases of a complete tear, the
114:hunters, as well as athletes (such as
7:
218:joint of the thumb, resulting in a
25:
1061:Dislocations, sprains and strains
895:Anterior cruciate ligament injury
388:Journal of Ultrasound in Medicine
192:Partial-thickness tear of the UCL
666:
1:
138:case of gamekeeper's thumb).
88:) is a type of injury to the
504:10.1016/j.injury.2009.01.107
145:include pain, swelling, and
358:"Skier's thumb - aftercare"
344:"Skier's thumb - aftercare"
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562:10.1302/0301-620X.37B1.148
451:10.1007/s11552-008-9145-8
90:ulnar collateral ligament
54:
45:
256:adductor pollicis muscle
1031:Achilles tendon rupture
1026:Patellar tendon rupture
18:Gamekeeper's thumb
243:
305:, tearing the UCL by
237:
905:Patellar dislocation
675:at Wikimedia Commons
550:J Bone Joint Surg Br
527:"Gamekeeper's Thumb"
222:or tear of the UCL.
126:grasping ski poles.
793:Dislocated shoulder
242:to brace the joint.
179:metacarpophalangeal
846:Gamekeeper's thumb
803:Separated shoulder
762:Dislocation of jaw
680:Gamekeeper's thumb
639:External resources
319:Bennett's fracture
244:
130:Signs and symptoms
78:Gamekeeper's thumb
33:Gamekeeper's thumb
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1044:
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982:Rotator cuff tear
950:
949:
936:High ankle sprain
671:Media related to
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401:10.1002/jum.14575
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27:Medical condition
16:(Redirected from
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1066:Overuse injuries
1004:Pulled hamstring
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910:Knee dislocation
890:Tear of meniscus
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394:(9): 2117–2133.
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324:Rolando fracture
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868:Hip dislocation
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209:In addition to
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151:thenar eminence
141:Characteristic
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80:(also known as
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92:(UCL) of the
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82:skier's thumb
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1036:Shin splints
841:Pulled elbow
809:ALPSA lesion
720:subluxations
716:Dislocations
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618:
582:
578:
556:(1): 148–9.
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531:. Retrieved
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498:(6): 652–6.
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491:
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445:(1): 12–18.
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271:spica splint
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77:
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66:Hand surgery
533:11 February
529:. About.com
411:2434/780964
252:aponeurosis
200:aponeurosis
169:collateral
149:around the
120:goalkeepers
118:and soccer
105:gamekeepers
70:orthopedics
38:Other names
1055:Categories
330:References
147:ecchymosis
974:upper arm
814:SLAP tear
781:upper arm
741:ligaments
648:eMedicine
589:eMedicine
459:1558-9447
230:Treatment
161:Diagnosis
61:Specialty
970:Shoulder
942:Turf toe
777:Shoulder
767:Whiplash
570:14353966
512:19389670
477:18975032
420:29480577
313:See also
303:ski pole
292:abducted
171:ligament
135:Symptoms
109:Scottish
98:proximal
86:UCL tear
41:UCL tear
961:tendons
956:Muscles
833:forearm
728:strains
724:sprains
468:2654954
281:History
254:of the
183:chronic
101:phalanx
736:Joints
629:842.12
568:
510:
492:Injury
475:
465:
457:
418:
288:valgus
240:K-wire
220:sprain
211:skiing
124:skiers
996:thigh
920:Ankle
860:thigh
829:Elbow
175:acute
167:ulnar
143:signs
94:thumb
1016:and
1014:Knee
994:and
972:and
924:foot
922:and
880:and
878:Knee
858:and
831:and
779:and
754:neck
752:and
750:Head
726:and
624:9-CM
566:PMID
554:37-B
535:2017
508:PMID
473:PMID
455:ISSN
439:HAND
416:PMID
309:it.
112:fowl
107:and
1018:leg
992:Hip
958:and
882:leg
856:Hip
738:and
620:ICD
587:at
558:doi
500:doi
463:PMC
447:doi
406:hdl
396:doi
84:or
1057::
799:AC
789:GH
722:,
651::
627::
564:.
552:.
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392:37
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366:^
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718:/
708:e
701:t
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612:D
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443:4
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346:.
20:)
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