Skier’s thumb? Gamekeeper’s thumb?

June 11, 2010

The ulnar collateral ligament is a strong, fibrous band that maintains stability on the inside border at the base of the thumb. The ligament prevents excessive thumb movement away from the hand.

Source: Orthopod
click for larger view

How is it Injured?
Injuries usually occur as a result of a sporting mishap. It is commonly seen in skier’s, footballers and rugby players. The ligament may also be directly damaged as a direct result of a fall or other trauma.

The ligament is typically damaged as the thumb is forced away from the hand stretching or rupturing the UCL.

UCL injuries are commonly referred to as

"Skier's thumb" AND "Gamekeeper's thumb"

Skier's thumb refers to an acute injury to the ulnar collateral ligament. This involves a significant stress to the ligament which stretches the ligament beyond its normal limit. If the ulnar collateral ligament is stretched far enough it will rupture

Gamekeeper's thumb refers to chronic injury causing a stretching of the ulnar collateral ligament over time. This is usually due to a lower grade repetitive trauma.

Signs and Symptoms?

Pain and tenderness over the base of the thumb
Swelling and or bruising over base of the thumb
Pain with movement of the affected thumb and difficulty gripping objects
Instability or catching of the thumb on movement

Treatment?
Treatment is highly varied and dependent on a number of factors.

Severity/grade of the injury
How long ago injury occurred
Patient age
Physical demands of the patient
Likely adherence of patient to protocols

If only a partial rupture has occurred patients are either placed in a mild cast or wrist splint (known as thumb spica) for 4 to 6 weeks.

If a complete rupture has occurred or there is gross instability of the thumb surgical intervention is most likely. Surgery is most effective when executed within the first few weeks following injury.

What is the recovery after ulnar collateral ligament repair?
Following surgery, patients will be placed in a cast for four to six weeks to protect the repaired ligament. During this time gentle range of movement exercises will be commenced progressing to stretching and strengthening exercises. Return to sports and full activity usually occurs 3 to 4 months after surgery.

Written by Nathan Luies · Filed Under Hand and Wrist, Sports Injury | View Comments

Hand Infections

May 11, 2010

When discussing about sports injury, we tend to focus on the big traumatic stuff like fractures, broken bones, dislocations, torn ligaments or massive swellings. Minor injuries are often brushed off especially with the more physical contact sports. After all, isn't discipline and perseverance part of the game?

As a result we tend to overlook hand infections, particularly lacerations (cuts and grazes) and for the more contact sports, bite wounds are not uncommon.

Lacerations

Cuts and grazes to the hands and fingers are a common occurrence in sports as a result of accidental contact with equipment, playing surfaces and between players or participants.

All cuts and grazes have the potential to become infected and should therefore be taken seriously.

Standard practice should be wash and clean all cuts and grazes hygienically with antiseptic solution monitored carefully for a number of days for any signs of infection.

If an infection develops the following signs symptoms may be present:

severe , throbbing pain
fever
movement of fingers reduced with pain
swelling and redness in the hand

If two or more of the above signs and symptoms are present then the risk of an infection is high and you should immediately report to the nearest doctor or hospital.

Bite Wounds

Skin of the hand broken by human teeth is a particularly dangerous wound. Human saliva contains such high levels of bacteria that these injuries should always be presumed to be contaminated. Skin is broken either from a punch to the mouth or a bite wound.

It is highly recommended that a course of a broad spectrum anti-biotic be administered by a doctor immediately and the wound not covered over or closed.

Why taken lacerations and bite wounds seriously?

Because due to the continuity of tendons of the hands into the wrist and forearms, infections can spread rapidly if not treated. Consequences can be highly destructive and hand infections frequently require hospital admissions for more specific anti-biotic therapy and or surgical intervention. In serious cases the tissue can become necrotic and die.

So please do take these sometimes rather innocuous and minor wounds seriously and seek medical treatment immediately if required.

Written by Nathan Luies · Filed Under Hand & Wrist (NonSport), Hand and Wrist | View Comments

Wii Right, Wrist-Wise

February 18, 2009

Wii Gamers often complain about wrist injuries. Here are some exercises and holding technique that Wii gamers can follow to better protect themselves from Repetitive Strain Injuries (RSI).

Written by Shiek Abdullah · Filed Under Featured, Hand & Wrist (NonSport), Hand and Wrist, Injury Prevention, Peripheral (NonSport), Sports Injury | View Comments