Thumb UCL Repair

Thumb UCL Repair

Thumbs can get sprained when the ligaments that allow them to stretch go beyond their limits and tear, usually occurring when the thumb is bent forcefully away from the palm. Most sprains involve the UCL, or ulnar collateral ligament, the most commonly torn thumb ligament and what connects the thumb to the hand on the index finger side of the hand. Sprained thumbs are often called “skier’s thumb” or “gamekeeper’s thumb” when it’s a gradual injury from repetitive twisting/grasping motions. There are 3 grades of sprain, with Grade 1 being Mild (stretched, but not torn), Grade 2 being Moderate (partial tears), and Grade 3 being severe (ligament is completely torn or pulled off bone). An avulsion fracture occurs when the ligament takes a small bone chip with it.

The most common cause of trauma to the thumb is falling onto an outstretched hand, but generally any type of forceful injury that pushes or pulls the thumb away from the palm can cause a UCL tear. Due to this, it is fairly common among athletes in sports involving catching and throwing like baseball.

You may have a UCL tear in your thumb if you are experiencing weakened abilities when grasping objects between the thumb and index fingers. The thumb or hand also usually swells and bruises after the injury; pain may only last for a week or two but functional problems will continue if untreated, like when writing, opening doors, and holding objects. If you have jammed your thumb hard into something or experienced intense pain , you may want to consult an orthopaedic specialist.

Mild thumb sprains can be treated nonsurgically with rest, bracing, ice packs, compression bandages to reduce swelling, and elevation above the heart for improved circulation. Surgical treatment would aim to reconnect the ligament to the bone; if there is an avulsion fracture, bone may be secured using a pin, screw, or bone anchor. In some extreme cases where ligament cannot heal, a new ligament can be created using a tendon.