Ulnar Collateral Ligament
Clearwater, Tampa, St Petersburg, Florida
The ulnar collateral ligament of the thumb attaches to the base of the thumb to the distal or furthermost end of the first metacarpal or wrist bone. It functions to stabilize the ulnar or lateral aspect of the first metacarpophalangeal joint (the first joint of the wrist and thumb). It is a frequent source of pain and injury and is commonly referred to as Gamekeeper’s thumb. It is often confused with other wrist type injuries, especially in chronic conditions.
In Gamekeeper’s thumb, abduction or outward injury to the first metacarpophalangeal joint – usually the result of the thumb being forced or pulled away from the rest of the fingers – resulting in injury to the ulnar collateral ligament. Historically, it was referred to as Gamekeeper’s thumb due to the motion involving the thumb when the heads of Game, especially chickens, were snapped.
Commonly, the injury can be caused by a number of athletic events, as well as overuse injuries exerting forceful tension on the thumb or wrist. Dr. Lox has found it frequently involved in skiing injuries, especially when using poles that do not break away when one falls. The mechanism of having the skiing poles strapped to your wrist can result in the thumb being forcefully displayed and abducted during the fall. This can be easily remedied by having breakaway skiing poles as opposed to poles that wrap around the wrist. It is somewhat inconvenient to chase one’s pole down the ski slopes, but is far more convenient than resulting in chronic ulnar collateral ligament injury.
When the ulnar collateral ligament is retracted and displaced proximally superficial to the adductor aponeurosis or fascia, this is referred to as Stener lesion. This occurs in approximately a third of all Gamekeeper’s thumb injuries and may be identified on magnetic resonance imaging as ligamentus injuries. The collateral ligament takes on a balled-up appearance on the MRI scan as do ligament and tendon injuries that are completely disrupted.
In most cases where the ligament is intact but injured, the result, if not allowed to heal properly, is chronic thumb or wrist pain. This may be treated easily with conservative measures; however, if conservative measures fail, surgery may be an option.
An alternative treatment for an ulnar collateral ligament injury would be an application of platelet-rich plasma (PRP) . Platelet-rich plasma is derived from the patient’s own blood. The resulting plasma is a concentration of growth and healing factors, and is injected into the affected area. Platelet-rich plasma has been useful in a variety of tendon and ligament injuries that are resistant to normal measures of healing.
If you suffer with an ulnar collateral ligament injury and your current treatment plan leaves you feeling hopeless, perhaps a fresh set of experienced eyes can change your outlook. Since 1990, Dennis M. Lox, M.D has applied his personal interests in sports medicine, cutting-edge regenerative medicine and chronic pain management to helping patients increase their quality of life. Contact us for an appointment at 727-462-5582.
Dennis M. Lox, MD, and the Florida Spine Center serve patients within the greater Tampa Bay area, including Clearwater, Tampa and St. Petersburg, as well as all of Florida and the US.
All statements, information or opinions provided by this website are provided for educational purposes only. We do not diagnose nor treat through this website or by telephone. As you consider any treatment, discuss them with your physician.