GAMEKEEPER'S THUMB

Course overview

THE METACARPOPHALANGEAL (MCP) JOINT OF THE THUMB PLAYS AN IMPORTANT ROLE IN FUNCTIONAL HAND MOVEMENTS SUCH AS GRIPPING AND PINCHING. THE RADIAL AND ULNAR COLLATERAL LIGAMENTS (UCL) ARE THE PRIMARY STABILIZERS TO VARUS AND VALGUS STRESS ON THIS JOINT. FUNCTIONALLY, THE UCL IS OF GREATER IMPORTANCE BECAUSE IT RESISTS RADIALLY DIRECTED FORCES DURING FORCEFUL GRASPING. THE TERM "GAMEKEEPER'S THUMB" WAS FIRST COINED IN 1955 BY CAMPBELL WHO IDENTIFIED UCL INJURIES AS AN OCCUPATIONAL DISEASE IN SCOTTISH GAMEKEEPERS. THE GAMEKEEPERS STRANGLED RABBITS USING THEIR THUMB AND INDEX FINGER, AND THE REPEATED VALGUS STRESSES RESULTED IN UCL INJURY AND CHRONIC INSTABILITY OF THE MCP JOINT. IN THE PRESENT DAY, THIS LESION OCCURS MORE FREQUENTLY IN ACUTE SPORTS-RELATED INJURIES. THIS ACTIVITY REVIEWS THE EVALUATION AND MANAGEMENT OF ULNAR COLLATERAL LIGAMENT INJURY OF THE FIRST METACARPOPHALANGEAL JOINT, ALSO KNOWN AS GAMEKEEPER'S THUMB OR SKIER'S THUMB. THIS ACTIVITY HIGHLIGHTS THE ROLE OF THE INTERPROFESSIONAL TEAM IN CARING FOR AFFECTED PATIENTS.