What is “Gamekeepers thumb”?

Gamekeepers thumb is a condition that affects the ulnar collateral ligament of the thumb. The ulnar collateral ligament is a strong band of tissue found on the inside of the thumb on the side closest to the index finger. It arises from the metacarpal (the bone which attaches the thumb and the hand) and the proximal phalanx (the bone in the lower part of the thumb). The ulnar collateral ligament is responsible for stopping excessive movement of the thumb away from the hand. This ligament keeps your thumb stable, especially when you pinch and grasp things.

What is the difference between Gamekeepers thumb and Skiers thumb?

A thumb ulnar collateral ligament injury is commonly called “skier’s thumb,” because falling on the ski slopes with your hand strapped to a ski pole is a common cause of this injury. Skier’s Thumb usually comes about as a result of trauma. Skier’s Thumb has been named after the thumb injuries seen in skiers when they fall on an outstretched hand, holding a ski pole. This position forces the thumb into an abducted and extended position, placing pressure on the ulnar collateral ligament which leads to a rupture or partial tear.

The term Gamekeeper’s Thumb is used when referring to an ulnar collateral injury caused by repetitive stress on the thumb during such activities as using a wrench, twisting electrical cords or wringing out heavy cloths. The difference between Skiers and Gamekeepers thumb is that the latter occurs as a result of  a non-traumatic overuse injury that gradually injures the ulnar collateral ligament.

What are the symptoms of Gamekeepers thumb?

The symptoms of Gamekeepers thumb are similar to that of Skiers thumb, with an addition of a history of overuse. Pain and swelling in the thumb or wrist, tenderness of the thumb on the side closest to the index finger, instability of the thumb, and difficulty gripping or pinching objects.

What is the management of Gamekeepers thumb?

The treatment and management of Gamekeeper’s Thumb is dependent on the age of the tear and the grade, along with the presence of any fractures or avulsions of the ligaments.

Complete ruptures of the ulnar collateral ligament require surgical intervention for repair within the first 3 weeks of the injury. Complete tears that are repaired after 3 weeks have an increased incidence of weakness and pain on pinch grasp. An associated increase in MCP joint arthritis is noted in the long term.

For small, nondisplaced avulsion fractures of the proximal phalanx that are found to be stable on stress testing, nonoperative treatment by a spica-type cast for 4 weeks can be completed with good results.

If you have an injury to your thumb, get in touch with our team here at Bend + Mend in the Sydney CBD.

Sophie O'Flaherty

About Sophie O'Flaherty

Sophie completed a Bachelor of Physiotherapy at the University College of Dublin and relocated to Sydney from Dublin in 2023. She uses a combination of manual therapy and exercise-based rehabilitation to get the optimal results for her patients, while encouraging them to take an active role in their recovery. Sophie is committed to staying up-to-date with the latest advancements in the field of physiotherapy and brings a wealth of knowledge and expertise to every treatment session. Sophie has an interest in Women’s Health, including pregnancy and pelvic floor dysfunction and has recently completed further study in this area. Sophie has completed clinical Pilates training and uses these skills and exercise-based techniques in both group classes and one to one rehabilitation.

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