Alycea Ohl: Period 7

Game Keeper’s

Thumb

What is it?

• Also can be known as UCL tear or skier’s thumb

• Anatomy of the Ulna collateral ligament in the thumb (UCL)

• The UCL is often torn or even ripped off of its insertion site into the proximal phalanx.

• Resulting from forced abduction or hyperextension of the proximal phalanx of the thumb

Gamekeeper:A person who manages an area of countryside to make sure there is enough game for shooting, or fish for angling. • Athletes may also have this injury to their

thumb.• Especially skiers

The chief difference between skiers and gamekeeper’s thumb is that Skier's thumb is generally considered to be an acute condition.Gamekeeper's thumb typically refers to a chronic condition which has developed as a result of repeated episodes of lower-grade hyper abduction over a period of time.

History

• 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.

• Others have noted that Scottish fowl or game hunters would develop this type of injury after carrying their game home, which they would attach to their thumb and drape over their shoulder.

• The term skier's thumb is derived from the fact that skiers often acquire this type of injury by falling against a planted ski pole, tearing the UCL by hyper abducting it.

Is it painful?• It is moderately painful compared to

similar injuries• In addition to skiing, this injury 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 joint of the thumb, resulting in a sprain or tear of the UCL.

Symptoms

• Instability of the MCP joint of the thumb

• Pain and weakness of the pinch grasp

• Pain and swelling over the thumb joint

• A weakened ability to grasp objects or perform tasks such as tying shoes and tearing paper.

• Blue or black discoloration of the thumb

Treatment/First Aid• Gamekeeper's thumb is more difficult to

treat because the UCL has lengthened and become thinner as a result of repeated injury.

• People with skier's thumb may be able to return to work and even skiing in a short period with proper rehabilitation.

• First Aid includes RICE• Make sure to ice and splint the thumb• Provide support with tape or a splint

Treatment• 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.

• 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.

• Most gamekeeper's thumb partial injuries are treated by simply immobilizing the joint in a thumb splint or a modified wrist splint and allowing the ligament to heal.

Citations

• http://en.wikipedia.org/wiki/Gamekeeper

• http://www.emedicinehealth.com/skiers_thumb/article_em.htm

• http://www.emedicinehealth.com/skiers_thumb/page6_em.htm#skiers_thumb_treatment

• http://www.emedicinehealth.com/skiers_thumb/page12_em.htm#skiers_thumb_pictures

• http://www.eatonhand.com/hw/hw016.htm