Gamekeeper's Thumb

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As your trusted hand and wrist specialists, we at JIS Orthopedics aim to provide you with valuable information about various conditions that can affect your hand health. In this article, we will discuss a common thumb injury called Gamekeeper’s Thumb, including its causes, symptoms, and treatment options. If you suspect you have this condition or want to learn more about it, you’ve come to the right place.

To learn more about hand and wrist conditions or to schedule a consultation, visit our offices in St. Clairsville or New Albany, Ohio today! Don’t let hand injuries hold you back—contact JIS Orthopedics today for personalized and expert care.

What is Gamekeeper's Thumb?

Gamekeeper’s thumb (also referred to as Skier’s Thumb) occurs when the ulnar collateral ligament (UCL) of the thumb sustains acute or chronic injury.

Ligaments are resilient, supple tissues that connect bone to bone. The UCL serves as the primary ligament situated near the base of the thumb’s inner aspect. The UCL links the metacarpal bone (at the base of the thumb) with the proximal phalanx (the middle thumb bone). It plays a crucial role in stabilizing the metacarpophalangeal (MCP) joint.

When the UCL experiences strain or tears, either partially or completely, it impairs the thumb’s ability to grasp or pinch effectively.

What Are the Symptoms of Gamekeeper's Thumb?

The symptoms of gamekeeper’s thumb may include the following:

Pain in the thumb joint between thumb and index finger
Localized bruising
Weakened grip
Reduced range of motion in thumb
Bump at the base of thumb (palm side) if the ligament is completely torn
Thumb misalignment

What Causes Gamekeeper's Thumb?

Gamekeeper’s Thumb can be caused by either acute injury or chronic overuse. Acute injury often occurs when the thumb is forcefully pulled away from the index finger during a fall on an outstretched hand, resulting in stretching or tearing of the UCL. This type of injury is commonly associated with skiing accidents where the skier falls without releasing the ski pole.

Chronic overuse injuries develop gradually over time due to the progressive wearing away of the UCL. Gamekeeper’s Thumb usually refers to this chronic form of injury.

Additionally, it’s worth noting that rheumatoid arthritis and nicotine use can weaken ligaments, increasing their susceptibility to injury.

How is Gamekeeper's Thumb Diagnosed?

Your orthopedic surgeon will begin by considering your medical history and a physical examination. The physical exam may involve a valgus stress test to see if there is any laxity in the affected thumb. You will likely receive a local anesthetic, as it can be very painful.

You will also likely be sent for image testing. X-rays will be used to see the condition of the bones. This will help rule out avulsion fracture. MRI (magnetic resonance imaging) scans or ultrasounds can be used to check out the severity of the torn ligament.

How is Gamekeeper's Thumb Treated?

The severity of the injury will dictate what treatment you will need. There are both non-surgical and surgical treatments for Gamekeeper’s thumb. A complete tear will not heal on its own and will require surgical intervention.

Non-Surgical Treatment

Non-surgical treatments may be used to treat symptoms and rehabilitate strained ligaments. The following are some of the non-surgical treatments that may be used in treating Gamekeeper’s thumb:

Ice packs: Used to reduce swelling during the first few days after injury.
NSAIDs: Also used to alleviate pain and reduce pain.
Use of thumb spica splint: You may be required to wear the splint for a few weeks.
Physical therapy: After the splint has been removed, physical therapy exercises will be prescribed to strengthen the thumb and improve mobility.

Surgical Treatment

If you suffer a UCL tear, then you may need surgery to reattach the ligament to the bone. Avulsion fractures and a Stener Lesion will also require surgery.

Surgery for Gamekeeper’s thumb is a minimally invasive procedure. Surgery will follow these basic steps:

A small incision is made to access the ligament.
The UCL ligament is reattached to the bone.
Any small pieces of avulsed bone will be removed.
Larger pieces of bone will be reattached using sutures.
The incisions will be glued.
The thumb is then placed in a splint or cast.
After a period of healing, physical therapy will help restore strength and range of motion of the thumb.

Contact JIS Orthopedics for Expert Hand Care

If you suspect you have Gamekeeper’s Thumb or are experiencing any hand-related issues, our skilled team of hand and wrist specialists at JIS Orthopedics is here to help. With locations in New Albany and St. Clairsville, Ohio, we offer comprehensive orthopedic care to address a wide range of conditions.

Our experienced surgeons can accurately diagnose your condition and recommend the most suitable treatment options to relieve your pain and restore hand function. Call JIS Orthopedics at 614-221-6331 or schedule an appointment online at our New Albany or St. Clairsville, OH location! Our experienced team is ready to provide you with the care you need.

Medically reviewed by AJ Julka, MD