Thumb Injuries

• JointsJoints

• Metacarpophalangeal JointMetacarpophalangeal Joint

• Interphalangeal Joint Interphalangeal Joint

– Thumb (IP)Thumb (IP)

Flexion/Extension

Thenar Eminence

Abduction/Adduction

Opposition

Pinch

Thumb Ulnar Collateral Ligament SprainGamekeeper’sThumb

– EtiologyEtiology• Sprain of UCL Sprain of UCL • Forceful abductionForceful abduction• Occasionally combined w/ hyperextensionOccasionally combined w/ hyperextension

Normal abduction

Normal abduction with stress

Abnormal abduction with stress

– Signs and SymptomsSigns and Symptoms

• Pain over UCL Pain over UCL

• Instability with radial Instability with radial deviationdeviation

• Weak pinchWeak pinch

• Painful pinchPainful pinch

Gamekeeper’s Thumb– ManagementManagement

• Immediate follow-upImmediate follow-up

• If instability existsIf instability exists

– Referral to orthopedistReferral to orthopedist

– X-ray to rule out fractureX-ray to rule out fracture

• If stable splint If stable splint

– 3 weeks or until pain free 3 weeks or until pain free

– Extend from wrist to end of thumb Extend from wrist to end of thumb

– Neutral positionNeutral position

• Thumb spica after splintingThumb spica after splinting

Thumb DislocationBennett’s Fracture

•Structurally unstableStructurally unstable

•Should never be reduced without x-ray Should never be reduced without x-ray

•Must be referred to an orthopedic surgeonMust be referred to an orthopedic surgeon