ORTHOPEDICS/HAND & WRIST
Skier’s thumb/Gamekeeper’s thumb
The ulnar collateral tendon (UCT) is a band of tough, fibrous tissue that attaches the bones at the base of the thumb.
The (UCT) is one of the most important tendons at the base of the thumb joint.
This tendon prevents the thumb from pointing far from the hand.
A skier’s thumb is simply a damage to this UCT.
Damage to the ulnar collateral tendon (UCT) happens when this structure is pushed too far.
We distinguish two common expressive terms for damages to the UCT:
Skier’s thumb and Gamekeeper’s thumb
These two qualifications are frequently used confusedly, although they designate to some extent different damage shapes.
Skier’s Thumb
Severe Damage to the UCT
The skier’s thumb damage is a severe harm to the UCT.
This damage happens when the thumb is pulled away from the hand and important pressures and pain are placed on the UCT.
This damage occurs frequently to skiers when they fall down on their hand, handling the stick. This is why it is called skier’s thumb.
Gamekeeper’s Thumb
Chronic Damage to the UCL
The qualification (Gamekeeper’s thumb) comes from the European gamekeepers who would end their game by clutching the head of the animal between their thumb and their index to break its neck.
“gamekeeper’s thumb” refers to a more chronic shape of damage that leads to loosening of the ulnar tendon over the time.
Gamekeeper’s thumb is a chronic damage to the UCT because pain that cause last longer.
Signs
An ulnar collateral tendon (UCT) damage happens most frequently due to sports damages, specifically with skiers and football players.
It also occur as the result of a fall or other shock.
Enduring a serious tear of the UCT is frequently described by severe pain and swelling directly over the torn tendon at the thumb base. Consequently, patients will have difficult time to grasping objects or holding objects firmly.
X-rays or MRIs are commonly the two tests used to confirm the diagnosis of a UCT
Sometimes x-rays show a small piece of bone pulled of the thumb. This bone, called a Stener injury, is a sign that an operation is regularly required, because this Stener will prevent the UCT from recovering in its appropriate situation.
Therapy
Therapy depends on numerous issues such as:
- damage degree
- When this damage had happened
- The patient age
- The patient physical difficulties.
- If the slash is partial or total
Immobilizing the damaged tendon helps faster healing and the thumb is protected from further damage.
When surgery is needed, the specialist will repair the torn ends of the tendon back together.
In case the UCT damage is older, either another structure will be transferred to reconstruct this UCT, or one of the muscles at the base of the thumb will be advanced to compensate for the torn tendon.
Note that most patients are able to get back to sports activity, three to four months after surgery.
Surgery risks
inflammation, healing difficulties, and sometimes nerve damage. Insufficient rehabilitation time or inadequate protection following surgery can lead to thumb painfulness and weakness.
A final word
Even if sometimes, immobilization with a bandage or cast will help healing a damage to the UCT of the thumb, pain and instability are frequently the result of such a damage.
For these reasons, people with more important damages to the UCT should decide a surgical process to reconstruct this damage.