An avulsion fracture at the ulnar base of the first proximal phalange, linked to the ulnar...
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Transcript of An avulsion fracture at the ulnar base of the first proximal phalange, linked to the ulnar...
![Page 1: An avulsion fracture at the ulnar base of the first proximal phalange, linked to the ulnar collateral ligament of the metatarsophalangeal joint.](https://reader036.fdocuments.us/reader036/viewer/2022082505/56649ea25503460f94ba6330/html5/thumbnails/1.jpg)
Gamekeepers thumb
An avulsion fracture at the ulnar base of the first proximal phalange, linked to the ulnar collateral ligament of the metatarsophalangeal joint.
![Page 2: An avulsion fracture at the ulnar base of the first proximal phalange, linked to the ulnar collateral ligament of the metatarsophalangeal joint.](https://reader036.fdocuments.us/reader036/viewer/2022082505/56649ea25503460f94ba6330/html5/thumbnails/2.jpg)
Anatomy of gamekeepers thumb
• Gamekeepers thumb is an insufficiency of the ulnar collateral ligament (UCL) of the metatarsophalangeal (MCP) joint of the thumb
![Page 3: An avulsion fracture at the ulnar base of the first proximal phalange, linked to the ulnar collateral ligament of the metatarsophalangeal joint.](https://reader036.fdocuments.us/reader036/viewer/2022082505/56649ea25503460f94ba6330/html5/thumbnails/3.jpg)
Mechanism of Injury• Skiing accidents are the most common
causes of injuring this ligament. Injuries of this ligament make up 8-10% of all skiing accidents.
• A fall on an outstretched hand with a ski pole in the palm of your hand creates the force to stress the thumb and stretch or tear the ligament
• Usually, the injury is not created by a regular fall
• May be caused in automobile accidents when the thumb is draped over the steering wheel
![Page 4: An avulsion fracture at the ulnar base of the first proximal phalange, linked to the ulnar collateral ligament of the metatarsophalangeal joint.](https://reader036.fdocuments.us/reader036/viewer/2022082505/56649ea25503460f94ba6330/html5/thumbnails/4.jpg)
Treatment• Within the first few weeks of
injury, surgery is usually most effective
• If the ligament is torn from the bone, then the torn end will be sutured down itself.
• If the injury is older then a direct repair is not possible. One of the muscles at the base of the thumb will have to be advanced to compensate for the torn ligament.
• If you have no treatment, you most likely will develop arthritis
![Page 5: An avulsion fracture at the ulnar base of the first proximal phalange, linked to the ulnar collateral ligament of the metatarsophalangeal joint.](https://reader036.fdocuments.us/reader036/viewer/2022082505/56649ea25503460f94ba6330/html5/thumbnails/5.jpg)
Recovery• Flexion• Extension• Side to side• Thumb strengthening:• Finger spring: Place a large
rubber band around the outside of your thumb and the rest of your fingers. Open your fingers to stretch the rubber band. Do 3 sets of 10
• Grip strengthening• Wrist flexion• Wrist extension
RECOVERY TIME3-4 months