Department of hand surgery & Microsurgery.

Ligament injuries of thumb

What are the important ligaments of the thumb ?

Ligaments are a thick band of tissues which connect the bones. Most commonly injured thumb ligaments are around its MCP joint (Thumb base joint)

Thumb MCP joint has two important ligaments

  • Ulnar collateral ligament or UCL ( 10 times more commonly injured than RCL)
  • Radial collateral ligament or RCL.

Both ligaments are very important in the use of the thumb.

How are ligaments injured ?

Ligament injuries are often due to a sudden fall with the thumb hitting the floor and body weight of the person coming on the thumb. Depending on the stress on the part of the thumb either radial collateral ligament or ulnar collateral ligament may fail. Ulnar collateral ligament injuries are more common than radial collateral ligament injuries .Acute ulnar collateral ligament injuries are known as “Skier’s thumb”. Chronic ulnar collateral ligament injuries are known as “ Game keeper’s thumb “.

Diagnosis

Injury is often diagnosed by clinical examination of patients. X ray of the thumb and ultrasound of the joint helps in confirming the diagnosis.

How are these injuries treated ?

Acute partial injuries and certain types of ligament injuries with bony avulsion are managed successfully with plaster for 4-6 weeks. Acute complete injuries which are not amenable to plaster , are treated surgically. Chronic ligament injuries often need reconstruction with tendon graft

How long does it take for recovery ?

Your hand will be protected with a plaster for one month. Hand therapy is started after plaster removal and follow up x ray. You may take one month to regain your thumb movements. You will be permitted to do activities which involve firm thumb pinch, only after 3 months from the date of surgery.