Injury to the ulnar collateral ligament of the thumb is very common and can be disabling when missed or left untreated. We present a review of literature and our preferred way of management.
AbrahamssonSOSollermanCLundborgG. Diagnosis of displaced ulnar collateral ligament of the metacarpophalangeal joint of the thumb. J Hand Surg [Am].1990;15:457–60. doi:10.1016/0363-5023(90)90059-Z.
2.
CampbellCS. Gamekeeper's thumb. J Bone Joint Surg Br.1955;37-B(1):148–9.
3.
CarrDJohnsonRJPopeMH. Upper extremity injuries in skiing. Am J Sports Med.1981;9:378–83. doi:10.1177/036354658100900607.
4.
CoonradRWGoldnerJL. A study of the pathological findings and treatment in soft-tissue injury of the thumb metacarpophalangeal joint: with a clinical study of the normal range of motion in one thousand thumbs and a study of post mortem findings of ligamentous structures in relation to function. J Bone Jt Surg Am.1968;50:439–51.
5.
DemirelMTurhanEDereboyF. Surgical treatment of skier's thumb injuries. Case Rep Rev Lit The Mt Sinai J Med.2006;73–5:818–21.
6.
DerkashRSMatyasJRWeaverJK. Acute surgical repair of the skier's thumb. Clin Orthop Relat Res.1987;216:29–33, March.
7.
DeyRGreenAD. The danger in a handshake—an unusual case of ulnar collateral ligament rupture injury. Int J Care Injured.2003;34:535–6.
8.
EbrahimFSDe MaeseneerMJagerT. US diagnosis of UCL tears of the thumb and Stener lesions: technique, pattern-based approach, and differential diagnosis. Radiographics2006;26 (4):1007–20. doi:10.1148/rg.264055117.
9.
FraserBVeitchJFiroozbakhshK. Assessment of rotational instability with disruption of the accessory collateral ligament of the thumb MCP joint: a biomechanical study hand online first. Hand2008;3:224–8.
10.
GieleHMartinJ. The two level ulnar collateral ligament of the metacarpophalangeal joint of the thumb. J Hand Surg J Br Soc Surg Hand.2003;28(1):92–3.
11.
GlickelSZMalerichMPearceSMLittlerJW. Ligament replacement for chronic instability of the ulnar collateral ligament of the metacarpophalangeal joint of the thumb. J Hand Surg [Am].1993;18:930–41. doi:10.1016/0363-5023(93)90068-E.
12.
GlickelSBarronOACatalanoLW. Dislocations and ligament injuries in the digits, green, hotchkiss, pederson, wollfe: greens operative hand surgery. 5th ed. New York: Churchill-Livingstone; 2005. p. 367–73.
13.
HarperMTChandnaniVPSpaethJ. Gamekeeper thumb: diagnosis of ulnar collateral ligament injury using magnetic resonance imaging, magnetic resonance arthrography and stress radiography. J Magn Reson Imaging.1996;6(2):322–8. doi:10. 1002/jmri.1880060211.
14.
HerganKMittlerCOserW. Ulnar collateral ligament: differentiation of displaced and nondisplaced tears with US and MR imaging. Radiology1995;194(1):65–71.
15.
HeymanP. Injuries to the ulnar collateral ligament of the thumb metacarpophalangeal joint. J Am Acad Orthop Surg.1997;5:224–9.
16.
HeymanPGelbermanRHDuncanKHippJA. Injuries of the ulnar collateral ligament of the thumb metacarpophalangeal joint. Biomechanical and prospective clinical studies on the usefulness of valgus stress testing. Clin Orthop Relat Res.1993;292:165–71.
17.
HuberJBickertBGermannG. The Mitek mini anchor in the treatment of the gamekeeper's thumb. Eur J Plast Surg.1997;20:251–5. doi:10.1007/BF01159486.
18.
HusbandJBMcPhersonSA. Bony Skier's Thumb Injuries. Clin Orthop Relat Res.1996;327:79–84. doi:10.1097/00003086-199606000-00012.
19.
IsaniAMeloneCPJr.. Ligamentous injuries of the hand in athletes. Clin Sports Med.1986;5:757–72.
20.
JonesSCrawfordI. Plaster or functional splint in gamekeepers thumb. Emerg Med J.2002;19:324–30. doi:10.1136/emj.19.4.324.
21.
KaplanSJ. The Stener lesion revisited: A case report. J Hand Surg.1998;23(5):833–6, September.
22.
KoslowskyTCMaderKGausepohlT. Ultrasonographic stress test of the metacarpophalangeal joint of the thumb. Clin Orthop Relat Res.2004;427:115–9. doi:10.1097/01.blo.0000136907.90559.5c.
23.
LaneLB. Acute Grade III ulnar collateral ligament ruptures. Am J Sports Med.1991;19:234–8.
24.
LeeSKKubiakENLawlerE. Thumb metacarpophalangeal ulnar collateral ligament injuries: a biomechanical simulation study of four static reconstructions. J Hand Surg.2005;30 (5):1056–60, September.
25.
LouisDSHuebnerJJHankinFM. Rupture and displacement of the ulnar collateral ligament of the metacarpophalangeal joint of the thumb. J Bone Joint Surg Am.1986;68-A:1320–6.
26.
MinamiAAnKACooneyWP. Ligamentous structures of the metacarpophalangeal joint: a quantitative anatomic study. J Orthop Res.1984;1(4):361–8. doi:10.1002/jor.1100010404.
27.
NeviaserRJWilsonJNLievanoA. Rupture of the ulnar collateral ligament of the thumb (gamekeeper's thumb): correction by dynamic repair. J Bone Joint Surg Am.1971;53:1357–64.
28.
NoszianI. Ulnar collateral ligament: differentiation of displaced and nondisplaced tears with US. Radiology1995;194: 61–3.
29.
PalmerAKLouisDS. Assessing ulnar instability of the metacarpophalangeal joint of the thumb. J Hand Surg [Am].1978;3(6):542–6.
30.
PichoraDRMcMurtryRYBellMJ. Gamekeepers thumb: a prospective study of functional bracing. J Hand Surg [Am].1989;14(3):567–73, May.
31.
RomanoWMGarvinGBhayana. The spectrum of ulnar collateral ligament injuries as viewed on magnetic resonance imaging of the metacarpophalangeal joint of the thumb. CarJ2003;544:243–8, October.
32.
SakellaridesHT. DeWeese Instability of the metacarpophalangeal joint of the thumb. Reconstruction of the collateral ligaments using the extensor pollicis brevis tendon. J Bone Joint Surg Am.1976;58:106–12.
33.
SartorisAJM. Gamekeeper thumb: comparison of MR arthrography with conventional arthrography and MR imaging in cadavers. Radiology1998;206(3):737–44.
34.
SmithRJ. Post-traumatic instability of the metacarpophalangeal joint of the thumb. J Bone Joint Surg Am.1977;59:14–21.
35.
StenerB. Displacement of the ruptures ulnar collateral ligament of the metacarpophalangeal joint of the thumb. J Bone Joint Surg Br.1962;44-B:869–79.
36.
SusicDHansenBRHansenTB. Ultrasonography may be misleading in the diagnosis of ruptured and dislocated ulnar collateral ligaments of the thumb. Scand J Plast Reconstr Surg Hand Surg.1999;33(3):319–20. doi:10.1080/02844319950159307.
37.
YamanakaKYoshidaKInoueH. Locking of the metacarpophalangeal joint of the thumb. J Bone Joint Surg Am.1985;67:782–7.
38.
YoshidaRHouseHOPattersonRM. Motion and morphology of the thumb metacarpophalangeal joint. J Hand Surg.2003;28–5:753–7, September.
