59 results match your criteria Gamekeeper's Thumb
J Ultrasound Med 2018 Sep 26;37(9):2117-2133. Epub 2018 Feb 26.
Cabinet Imagerie Médicale, Geneva, Switzerland.
Injuries to the collateral ligaments of the metacarpophalangeal (MCP) and interphalangeal (IP) joints are commonly encountered in both athletes and nonathletes. They require prompt evaluation to ensure proper management and prevent loss of joint motion and permanent disability. Imaging is often required to confirm the diagnosis and assess injury severity. Read More
Hand (N Y) 2018 Sep 24;13(5):581-585. Epub 2017 Aug 24.
1 Brown University, Providence, RI, USA.
Background: A complete thumb ulnar collateral ligament (UCL) repaired with 1-suture anchor has been demonstrated to be significantly weaker compared with the intact UCL. The objective of this study is to test the biomechanical strength of a 2-anchor thumb UCL repair.
Methods: Nine paired fresh-frozen hands were used for this biomechanical analysis. Read More
Orthop Traumatol Surg Res 2017 10 30;103(6):923-926. Epub 2017 May 30.
Unité de chirurgie de la main et du membre supérieur, services de chirurgie orthopédique 1 et 2, hôpital Trousseau, CHRU de Tours, avenue de la République, 37170 Chambray-lès-Tours, France.
Background: Severe sprain of the thumb metacarpo-phalangeal joint (TMCPJ) is a common injury whose functional outcome is good when repair is performed at the acute stage. The diagnosis is often missed, however, leading to chronic instability. The optimal treatment of chronic TMCPJ instability is controversial. Read More
Hand (N Y) 2016 09 14;11(3):303-309. Epub 2016 Mar 14.
Mayo Clinic, Rochester, MN, USA.
The purpose of this study is to evaluate long-term outcomes of ligamentous repair rather than reconstruction for chronic thumb ulnar collateral ligament (UCL) injuries. Patients at least 15-years status-post repair of a chronic (greater than 6 weeks) UCL tear were contacted for clinical evaluation, radiographs, and postoperative outcome questionnaires, including the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, visual analog scale (VAS) pain scale, and study-specific questions. Twelve of 21 (57%) living patients were available for long-term, greater than 15-year follow-up (average 24. Read More
Ultrasonography 2016 Apr 24;35(2):110-23. Epub 2015 Nov 24.
Department of Radiology, Incheon Baek Hospital, Incheon, Korea.
The recent development of advanced high-resolution transducers has enabled the fast, easy, and dynamic ultrasonographic evaluation of small, superficial structures such as the finger. In order to best exploit these advances, it is important to understand the normal anatomy and the basic pathologies of the finger, as exemplified by the following conditions involving the dorsal, volar, and lateral sections of the finger: sagittal band injuries, mallet finger, and Boutonnière deformity (dorsal aspect); flexor tendon tears, trigger finger, and volar plate injuries (volar aspect); gamekeeper's thumb (Stener lesions) and other collateral ligament tears (lateral aspect); and other lesions. This review provides a basis for understanding the ultrasonography of the finger and will therefore be useful for radiologists. Read More
Am J Orthop (Belle Mead NJ) 2015 Aug;44(8):359-62
Department of Orthopaedic Surgery, University General Hospital of Ciudad Real, Ciudad Real, Spain.
In any thumb injury, particularly one caused by hyperabduction, an ulnar collateral ligament lesion (gamekeeper's or skier's thumb) must be considered. If the diagnosis is suspected, and radiographs show no fracture, comparative radiographs should be obtained in forced valgus. This examination, which uses a stress test to cause joint tilt, is crucial in making an accurate diagnosis and deciding on the most appropriate therapeutic approach. Read More
Clin Sports Med 2015 Jan 11;34(1):117-26. Epub 2014 Oct 11.
Hand Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8233, St Louis, MO 63110, USA. Electronic address:
Thumb metacarpophalangeal ulnar and radial collateral ligament injuries occur frequently in the competitive athlete. Collateral ligament integrity is essential to joint stability, pinch strength, and pain-free motion. Acute rupture of the ulnar collateral ligament is due to a sudden radial deviation force on the abducted thumb and is referred to as skier's thumb. Read More
J Hand Surg Am 2015 Jan 7;40(1):90-5. Epub 2014 Oct 7.
Christine M. Kleinert Institute, Louisville, KY. Electronic address:
Purpose: To investigate by magnetic resonance imaging the degree of ulnar collateral ligament (UCL) displacement in order to create a simple classification to aid in determining which UCL injuries require surgery.
Methods: We evaluated 43 cases of UCL injury with a dedicated extremity magnetic resonance imaging and measured the degree of ligament displacement. This was correlated to clinical outcome with planned surgical intervention reserved for patients with a Stener lesion. Read More
J Hand Surg Am 2014 Oct 16;39(10):1992-8. Epub 2014 Aug 16.
Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA. Electronic address:
Purpose: To evaluate return to play after complete thumb ulnar collateral ligament (UCL) injury treated with suture anchor repair for both skill position and non-skill position collegiate football athletes and report minimum 2-year clinical outcomes in this population.
Methods: For this retrospective study, inclusion criteria were complete rupture of the thumb UCL and suture anchor repair in a collegiate football athlete performed by a single surgeon who used an identical technique for all patients. Data collection included chart review, determination of return to play, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) outcomes. Read More
Orthop Surg 2014 Feb;6(1):1-7
Department of Orthopaedics, Jalan Batu Hampar, Bukit Baru, Malaysia.
Injury of the ulnar collateral ligament (UCL) of thumb can be incapacitating if untreated or not treated properly. This injury is notorious for frequently being missed by inexperienced health care personnel in emergency departments. It has frequently been described in skiers, but also occurs in other sports such as rugby, soccer, handball, basketball, volleyball and even after a handshake. Read More
J Hand Surg Am 2014 Mar 1;39(3):474-9. Epub 2014 Feb 1.
Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina. Electronic address:
Purpose: To determine whether variation in thumb metacarpophalangeal (MCP) joint pronosupination influences perceived ulnar collateral ligament (UCL) stability during clinical stress testing.
Methods: Twelve fresh-frozen specimens underwent sequential evaluation for the following conditions: ligament intact (LI), proper UCL deficient (-pUCL), and proper and accessory UCL deficient (UCL). Valgus stress testing was completed in both 0° and 30° MCP joint flexion for thumb pronation, neutral, and supination. Read More
Hand (N Y) 2013 Jun;8(2):205-9
Department of Orthopaedic Surgery, Maimonides Medical Center, 927 49th St., Brooklyn, NY 11219 USA.
Background: Diagnostic stress testing of ulnar collateral ligament (UCL) injuries of the thumb metacarpophalangeal (MCP) joint is pivotal to determining treatment. Comparison to the uninjured extremity and fluoroscopy-assisted examination are readily available modalities in the assessment of these patients, with 5-10° differences impacting treatment. Comparative examination, however, assumes that both extremities are normally equal, which has never been verified experimentally. Read More
Semin Musculoskelet Radiol 2012 Sep 9;16(4):338-49. Epub 2012 Oct 9.
Department of Medical Imaging, University of Arizona Medical Center, Tucson, Arizona 85724-5067, USA.
Hand injuries are common, accounting for up to 20% of emergency department visits nationwide. An understanding of the complex and detailed anatomical relationships of small joints facilitates the accurate diagnosis of many common sports-related injuries of the hand. We review the common ligamentous and tendinous injuries of the hand including collateral ligament injuries, gamekeeper's thumb, extensor mechanism injuries, pulley injuries, boutonniere deformities, and mallet and jersey lesions. Read More
Clin J Sport Med 2010 Mar;20(2):106-12
From the Department of Orthopaedic Surgery, University of Connecticut, Farmington, Connecticut 06030, USA.
Injury to the ulnar collateral ligament (UCL) of the thumb metacarpophalangeal (MCP) joint is a common entity encountered by the sports physician and orthopedic surgeon. The term "gamekeeper's thumb," which is sometimes used incorrectly to mean any injury to this ligament, refers to a chronic injury to the UCL in which it becomes attenuated through repetitive stress. In contrast, the term "skier's thumb" refers to an acute ligament injury as seen in skiers who fall on an abducted thumb or athletes who sustain a valgus force on an abducted thumb. Read More
Chir Main 2008 Oct 29;27(5):216-21. Epub 2008 Sep 29.
Unité SOS main, centre de chirurgie orthopédique et de la main, hôpitaux universitaires de Strasbourg, 10, avenue Achille-Baumann, 67403 Illkirch cedex, France.
Acute injury to the ulnar collateral ligament of the metacarpophalangeal joint of the thumb is a condition frequently seen by hand surgeons. Most can be treated conservatively except in the presence of a Stener lesion, when surgical treatment is necessary. What is difficult is to obtain the diagnosis of the Stener lesion. Read More
Ned Tijdschr Geneeskd 2008 Aug;152(33):1813-9
Erasmus MC-Centrum, afd. Huisartsgeneeskunde, kamer FF 304, Postbus 2040, 3000 CA Rotterdam.
There are 26 large climbing centres and 44 smaller indoor or outdoor climbing walls in The Netherlands at this time. Hand and finger injuries are the most common types of sport climbing injuries. Most injuries are caused by overstraining. Read More
Tech Hand Up Extrem Surg 2006 Sep;10(3):157-61
Department of Orthopaedics and Traumatology School of Medicine, Yeditepe University Istanbul, Turkey.
Avulsion fractures of the phalanges are among challenging problems encountered in the hand surgery. These fractures are characterized by existence of small bone fragments usually attached to a collateral ligament. They mostly occur in metacarpophalangeal and proximal interphalangeal joints. Read More
Orthopedics 2006 Aug;29(8):675-8
Miami Hand Center, Miami, FL 33176, USA.
Clin Sports Med 2006 Jul;25(3):527-42, vii-viii
Department of Radiology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA.
Injuries of the fingers and thumb in the athlete are common. Mallet finger, jersey finger, boutonniere deformity, Bennett and Rolando fractures, and gamekeeper's thumb are just a few of the injuries that can occur in athletes. A thorough understanding of the mechanism of injury, osseous and soft tissue abnormalities, imaging features, and treatment is important in the care of athletes. Read More
J Hand Surg Br 2002 Dec;27(6):542-5
8 Beale Street, Hamilton, New Zealand.
This study examines the treatment of 22 thumbs with symptomatic laxity of the ulnar collateral ligament of the metacarpophalangeal joint by ligament reconstruction 1 week to 10 years after injury. The existing ligament remnants were repaired in 13 thumbs and were re-attached to bone, using a bone anchor, in seven cases. Two ligaments were reconstructed using the extensor pollicis brevis tendon. Read More
Orthopedics 1999 May;22(5):476
Arthroscopy 1999 Apr;15(3):333-7
The Orthopaedic Center, Rockville, Maryland 20850, USA.
Although small joint arthroscopy has become commonplace over the past decade, relatively little attention has been paid to the investigation and clinical utility of metacarpophalangeal (MP) joint arthroscopy. The literature is scant in this area and consists of only a handful of case reports. In addition, the arthroscopic anatomy of the MP joint has not as yet been reported. Read More
Orthopedics 1998 Dec;21(12):1312, 1308-10
Department of Radiology, Loyola University Medical Center, Maywood, Ill 60153, USA.
Handchir Mikrochir Plast Chir 1998 Mar;30(2):125-8
Department of Orthopaedic Surgery, Hyogo College of Medicine, Japan.
A new method for the reconstruction of chronic ulnar collateral ligament instability of the metacarpophalangeal joint is described. Reconstruction with our method using interference screw, adequately maintains both anatomical fiber direction and physiological tension in the grafted ligaments of adequate strength to reduce the immobilization period. Read More
Am J Sports Med 1997 Mar-Apr;25(2):275
Eur Radiol 1997 ;7(1):65-9
Zentrales Institut für Radiologie, LKH Feldkirch, Carinagasse 47, A-6800 Feldkirch, Austria.
The gamekeeper's or skier's thumb is a very common injury. Nondisplaced tears of the ulnar collateral ligament of the thumb (UCL) may be treated conservatively. For that reason an accurate diagnosis is mandatory for choosing the correct therapy. Read More
Am Fam Physician 1996 Apr;53(5):1775-81
Northeastern Ohio Universities College of Medicine, Rootstown, USA.
Injury to the ulnar collateral ligament of the thumb, once a common chronic occupational injury occurring in British gamekeepers, is now most frequently an acute sports-related injury in skiers, football players and other athletes. Differentiation of complete versus partial tears of the ligament is crucial because the treatment for complete tears is surgical. Radiographic evaluation, while important, has a limited role. Read More
J Trauma 1996 Apr;40(4):660-2
Division of Neurosurgery, University of California, Davis-East Bay, Oakland 94602, USA.
A case of gamekeeper's thumb resulting from a motor vehicle accident is presented. This injury was complicated by the onset of reflex sympathetic dystrophy. An overview of the presentation and management of these disorders, which may result in severe disability without prompt recognition and therapy, is submitted for discussion. Read More
Orthopedics 1995 Dec;18(12):1161-5
Department of Orthopedic Surgery, Mt Sinai Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
Thirty-nine patients diagnosed with 40 acute complete ruptures of the ulnar collateral ligament of the thumb metacarpophalangeal joint were treated primarily with thumb spica splint immobilization. Duration of splinting ranged from 8 to 12 weeks. Thirty-four of these injuries (85%) followed for 1 to 5 years (average 2. Read More
Am J Sports Med 1995 Mar-Apr;23(2):222-6
Department of Orthopaedics and Rehabilitation, University of New Mexico Health Sciences Center, Albuquerque 87131, USA.
Ten consecutive patients with 11 complete ulnar collateral ligament tears who had early surgical repair were evaluated at an average of 42 months' followup. The mean arc of motion at the metacarpophalangeal joint at 50.9 degrees was less than the 73. Read More
AJR Am J Roentgenol 1994 Dec;163(6):1431-4
Department of Radiology, John L. Doyne Hospital, Doyne Clinic, Milwaukee, WI 53226.
Objective: The ulnar collateral ligament bridges the ulnar aspect of the first metacarpal and the proximal phalanx and functions as a major stabilizer of the first metacarpophalangeal joint. Acute or chronic injury of this ligament is referred to as gamekeeper's thumb. The objectives of this study were to (1) determine the MR appearance of the ulnar collateral ligament of the thumb in cadavers and volunteers and (2) analyze the MR findings in patients with gamekeeper's thumb, especially with regard to the value of MR in detecting clinically significant displacement of the ligament (Stener lesion). Read More
J Hand Surg Am 1994 Nov;19(6):1019-26
Department of Orthopaedics, Massachusetts General Hospital, Harvard University School of Medicine, Boston 02114.
We report 100 cases in which a tension-band technique was used to secure fixation of avulsion fractures within the digits. Included are 51 bony mallet fractures that were subluxed or irreducible, 38 displaced bony gamekeeper's fractures of the thumb, 8 fractures of the lateral phalangeal base, and 3 avulsion fractures that involved the base of the dorsal aspect of the middle phalanx. We evaluated results on the basis of clinical and x-ray film criteria. Read More
Orthop Rev 1994 Oct;23(10):797-804
Department of Orthopaedic Surgery, Temple University School of Medicine, Philadelphia, Pennsylvania.
Injuries to the ulnar collateral ligament complex in the thumb are common and require prompt attention. Early diagnosis is essential and must differentiate a partial ligament sprain from a complete disruption. Accurate diagnosis requires a precise examination and roentgenographic evaluation. Read More
Injury 1994 Jan;25(1):21-3
Department of Orthopaedic Surgery, Royal Infirmary of Edinburgh, UK.
A consecutive series of patients who underwent operation for acute rupture of the ulnar collateral ligament of the thumb during a 3 year period from 1985 to 1988 at the Royal Infirmary of Edinburgh were identified. In total 44 patients sustained this injury of whom 19 were available for clinical assessment. The minimum period of follow-up was 17 months (mean 32 months). Read More
Ann Chir Main Memb Super 1993 ;12(4):257-61; discussion 262
Department of Orthopaedic Surgery, Hospital Cantonal Fribourg, Switzerland.
Twenty-one patients presenting clinically with a lesion of the ulnar collateral ligament complex of the metacarpo-phalangeal joint of the thumb underwent prospective diagnostic echography, in order to recognize the possible dislocation of the ligament over the adductor aponeurosis (Stener's lesion). Seven patients were treated surgically, the others conservatively. The accuracy of the echography was controlled by surgery and by the follow-up. Read More
Orthop Rev 1992 May;21(5):583-8
Mayo Graduate School of Medicine, Rochester, Minnesota.
We studied 33 patients with "gamekeeper's thumb" who underwent surgical treatment comprising ulnar collateral ligament (UCL) advancement in 14, arthrodesis in 11, reconstruction in 6, and primary repair in 2. Results were satisfactory in 76% of the cases and unsatisfactory in 24%. From our study and review of the literature, we concluded that the best results are obtained after surgical treatment in the acute stage, because results are inconsistent and poorer after treatment of chronic lesions; reconstructive procedures based on the surgical pathology are recommended over UCL advancement and late primary repairs; and arthrodesis is a reliable salvage procedure. Read More
Hand Clin 1992 Feb;8(1):121-9
Hand Surgical Associates, New England Baptist Hospital, Boston, MA 02120.
Most rheumatoid patients will present with one or more thumb deformities at some stage of their clinical history. The goal of treatment is restoration and maintenance of stable and painless motion. Treatment is based on the type and stage of the deformity. Read More
Orthop Clin North Am 1992 Jan;23(1):41-8
Department of Orthopaedics, University of California, Davis, Sacramento.
The term gamekeeper's thumb is widely used interchangeably with skier's thumb in reference to acute or chronic tears of the ulnar collateral ligament of the thumb MCP joint. The frequency of thumb injury in alpine skiing has not changed with recent changes in pole design. Release of the pole from the hand prior to impact with the ground will minimize injury. Read More
Orthopedics 1991 Jul;14(7):792-3
Department of Orthopedic Surgery, University of Connecticut Health Center, Farmington 06032.
Burns 1991 Feb;17(1):50-1
Ross Tilley Burn Centre, Wellesley Hospital, Toronto, Canada.
Three patients are presented with significant flame burns, resulting from accidents occurring during 'special effects' situations in the entertainment industry. These occurred as a result of the spontaneous combustion of various materials, during events in live theatre (gun powder), a television commercial (artificial 'rocket fuel'), and a video presentation (magnesium oxide). All three patients sustained flash burns to the face and hands. Read More
Sports Med 1990 Aug;10(2):122-31
Department of Orthopedics, Mayo Clinic, Rochester, Minnesota.
Ice hockey is a fast-paced game involving both finesse and controlled aggression. Injuries are related to direct trauma (80%) and overuse (20%), with high puck velocities, aggressive stick use, and body checking (collisions) accounting for most of these. A participant can anticipate an injury after playing 7 to 100 hours of hockey, depending on his age, and most injuries are caused during the actual game rather than during practice. Read More
Mil Med 1989 May;154(5):236-8
A retrospective analysis of the radiographic records of 1653 sailors aboard the USS Enterprise was performed during the author's recent reserve assignment. For the period 1985 to 1987, 102 radiographically recognizable injuries were discovered in the study group. The high rate (53. Read More
Am Fam Physician 1988 Dec;38(6):127-30
University of Michigan Hospitals, Ann Arbor.
Injuries to the ulnar collateral ligament of the thumb metacarpophalangeal joint can result in significant pain and instability. Patients with this injury have severe difficulties with pinching and grasping objects. Avulsions of this collateral ligament from the proximal phalanx and midsubstance tears provide the usual mechanisms of injury. Read More
Ann Plast Surg 1988 Oct;21(4):382-7
Department of Plastic Surgery, Akron City Hospital, OH.
Isolated rupture of the radial collateral ligament of the metacarpophalangeal joint of the fifth digit is a rare but disabling injury. Treatment is complicated by the influence of the hypothenar musculature, which deviates toward the ulna and flexes the digit. We have managed two cases, one chronic and one acute, by open reduction and repair. Read More
J Emerg Med 1984 ;1(4):345-7
Rupture of the ulnar collateral ligament of the metacarpophalangeal joint of the thumb is an injury frequently encountered by the emergency physician. The mechanism of injury is usually a fall onto the abducted thumb. The setting is frequently one of athletic endeavor, especially skiing, in which this is the most commonly encountered upper extremity injury. Read More
Orthopedics 1982 Apr;5(4):444-55
As in many sports, a wide spectrum of injuries is seen in skiing (Table 1). This includes injuries to the upper and lower extremities as well as miscellaneous injuries and medical problems (frostbite, hypothermia, and high altitude effects). Six relatively unique injuries in skiing will be presented in detail. Read More
Br J Sports Med 1980 Jul;14(2-3):92-6
J Trauma 1979 Feb;19(2):106-9
Arthrography of the metacarpo-phalangeal (MP) joint of the thumb was performed on 47 thumbs. The normal arthrographic appearance shows a closed joint space, whereas leakage of contrast material indicates tear of the joint capsule with or without an associated tear of a stabilizing ligament. Arthrographic demonstration of the heads of the adductor pollicis muscle was found to be specific for tear of the ulnar collateral ligament (UCL) of the MP joint, a tear which is commonly responsible for its instability. Read More
J Bone Joint Surg Am 1977 Jun;59(4):519-24
We reviewed 197 previously reported cases of acute rupture of the ulnar collateral ligament of the metacarpophalangeal joint with respect to anatomy, diagnosis, surgical findings, and management. A standardized roentgenographic technique in stress abduction of the thumb was developed from thirty normal patients. The correlation between the abduction arc as recorded by our technique, the arthogram, and surgical pathology in twenty patients is reported. Read More