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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

Radiographics 2016 Oct;36(6):1701-1716

From the Department of Radiology and Medical Imaging, Division of Musculoskeletal Imaging (U.R., J.L.P., N.C.N.), and Department of Orthopedic Surgery (S.E., A.B.C.), University of Virginia Health System, 1215 Lee St, Charlottesville, VA 22908.

Despite having many unique anatomic features relative to the other digits, the thumb has received little attention in the radiology literature. The thumb, with its opposable and prehensile abilities, enables fine manual dexterity. However, most radiologists have little familiarity with the structures that allow these dynamic movements, other than their recognition of the role of the ulnar collateral ligament in the setting of gamekeeper injury. 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 Clin 2011 Aug;27(3):383-94

Orthopaedic Specialists, Davenport, IA, USA.

This article covers new and emerging techniques in small joint arthroscopy in the hand. Recent improvement in the quality of small joint scopes and advancement in techniques have allowed for many new small joint arthroscopic procedures in the hand. The arthroscopic classification for thumb carpometacarpal (CMC) arthritis as well as treatment of each stage are described. Read More

Am J Emerg Med 2005 Oct;23(6):777-81

Department of Emergency Medicine, University of Louisville School of Medicine, Louisville, KY 40202, USA.

There are a significant number of hand and upper extremity injuries treated in US emergency departments (EDs) each year. Many of these involve the thumb and wrist. These injuries encompass the range from fractures, strains, and sprains to more specific injuries such as gamekeeper thumb and de Quervain tenosynovitis. Read More

Radiology 1998 Mar;206(3):737-44

Department of Radiology, Veterans Affairs Medical Center, San Diego, CA 92161, USA.

Purpose: To compare magnetic resonance (MR) arthrography with conventional arthrography and standard MR imaging in the evaluation of gamekeeper thumb.

Materials And Methods: Eighteen cadaveric thumbs with (n = 12) or without (n = 6) experimental abduction stress were examined with conventional arthrography, standard MR imaging, and MR arthrography. Standard MR imaging and MR arthrography were performed with 0. Read More

J Magn Reson Imaging 1996 Mar-Apr;6(2):322-8

Department of Radiology and Orthopaedic Surgery, Tripler Army Medical Center, Honolulu, HI, USA.

Ulnar collateral ligament (UCL) tears may be nondisplaced or displaced relative to the adductor pollicis aponeurosis. Nondisplaced tears typically heal with immobilization whereas displaced tears require surgery. Nineteen patients with UCL injuries were evaluated using MR Imaging (MRI), MR arthrography, and stress radiography (SR) to determine the efficacy of these techniques in differentiating nondisplaced from displaced UCL tears. Read More

Radiology 1994 Aug;192(2):477-80

Department of Radiology, Cantonal Hospital, Fribourg, Switzerland.

Purpose: To determine the value of ultrasound (US) in recognizing the ligamentary dislocation occasionally associated with gamekeeper thumb (Stener lesion). Detecting such dislocations is important because they require surgical repair, whereas nondisplaced ruptured ligaments respond to conservative treatment. This dislocation cannot be reliably diagnosed with standard methods, leading to unnecessary surgical procedures. Read More

Radiology 1993 Aug;188(2):553-6

Department of Radiology, University of New Mexico School of Medicine, Albuquerque 87131-5336.

Ulnar collateral ligament (UCL) injury of the first metacarpophalangeal joint (gamekeeper thumb) is common. If the UCL becomes displaced superficially to the adductor pollicis aponeurosis, surgical treatment has been advocated. Radiography cannot help differentiate between displaced and nondisplaced tears. Read More

Clin Orthop Relat Res 1987 Jan(214):113-20

Tension band wiring is a simple, predictable method of internal fixation for avulsion fracture in the hand. These fractures include the bony gamekeeper, bony mallet, and fractures associated with proximal interphalangeal joint trauma. By the placement of a small gauge wire through the insertion of the ligament or tendon onto the fracture fragment, the tension wire technique avoids many of the pitfalls of internal fixation and also takes advantage of its physiologic and biomechanical position. Read More