Thumb Sprains

(Gamekeeper Thumb)

Ligaments connect bones to each other across a joint; injury to a ligament often is called a “sprain.”  The joint between the thumb and the hand in what we call the first web space is a frequently injured joint.  When the thumb is “jammed” into a person, object, or the ground, the ulnar collateral ligament can be torn.  This is called “gamekeeper’s thumb.”  It also is called “skier’s thumb” after the skier who injures this ligament while holding a pole.  The radial collateral ligament (on the other side of this joint) also can be torn.

Gamekeeper Thumb ExamGamekeeper XR

Swelling, bruising, and pain are common with this injury.  X-rays usually are taken to make sure that there is no fracture.  If your ligament is partially torn, you likely will be able to heal this in a cast.  Sometimes, the ulnar collateral ligament gets trapped behind a piece of soft tissue in the area and will not heal without surgery.

If left untreated for several weeks or longer, the injury can be considered “chronic.” You might have pain with pinching activities or even with writing.  Ligament reconstruction or even fusing the joint (so that it doesn’t move) might be recommended.