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Hand & Upper Limb
intermediate
X-Type

Gamekeeper's Thumb (UCL Injury)

Thumb Injuries

A 28-year-old skier presents after falling onto an outstretched hand with the thumb abducted. She has pain and swelling at the base of the thumb on the ulnar side. On examination, there is tenderness over the ulnar collateral ligament of the thumb MCP joint, and stress testing reveals more than 30 degrees of laxity with valgus stress compared to the contralateral side, with no firm endpoint. Regarding ulnar collateral ligament injuries of the thumb (gamekeeper's thumb):

Mark each as TRUE or FALSE

A

The UCL is the primary stabilizer of the thumb MCP joint against valgus stress; it has a proper coll...

B

The Stener lesion is a critical concept: when the UCL ruptures from its distal insertion, it may bec...

C

The UCL is a secondary stabilizer; the proper collateral ligament is taut in extension; the RCL is m...

D

Clinical examination: stress testing compares laxity to contralateral thumb; test in extension (acce...

E

Treatment: partial tears (stable on stress testing) are treated with immobilization in thumb spica c...

Answer the questions to see explanations

Click T (True) or F (False) for each option