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Avulsion fracture ulnar collateral ligament thumb metacarpophalangeal joint before and after surgery

Picture of procedure in operation room to treat Skier’s Thumb, Stener lesion.

Ulnar collateral ligament thumb metacarpophalangeal joint rupture and Stener lesion

What is Thumb Ligament Injury?

Thumb Ligament Injury generally involves one of the collateral ligaments of the thumb metacarpophalangeal joint, where the thumb meets the palm. “Skier’s Thumb” or “Gamekeeper’s Thumb” are the common names for injury to the collateral ligament on the side of the thumb joint closer to the index finger. The collateral ligament on the other side of thumb can also be injured. A Thumb Ligament Injury may involve partial or complete tearing of the ligament, or a fracture that occurs as the ligament is stretched and pulls away from the bone.

Symptoms of Thumb Ligament Injury

Thumb Ligament Injury is often associated with pain, swelling, and bruising. Motion of the thumb may be limited to pain and a feeling of stiffness. The thumb may also feel unstable when pressure is applied, such as with gripping or pressing.

Common Causes of Thumb Ligament Injury

Thumb Ligament Injury commonly occurs during skiing as the ski pole is pushed against the thumb during a fall, levering the thumb away from the index finger. The thumb can be injured by a ball during football and basketball games. Falling onto the hand can also cause Thumb Ligament Injury.

Diagnosing Thumb Ligament Injury

The diagnosis of Thumb Ligament Injury requires speaking with the patient to understand the mechanism of the accident. A careful physical exam is essential to identify the injured structure(s) and the degree of instability of the thumb. An x-ray is obtained to evaluate for possible associated fracture and to assess joint alignment with or without stress applied to the thumb to quantify injury. Sometimes an MRI is helpful to evaluate the integrity of the injured ligament.

Treatment Options for Thumb Ligament Injury

For partial Thumb Ligament Injury, icing, elevation and splinting can lead to recovery. Complete tears may benefit from surgery to repair the ligament and restore stability to the thumb. If a ligament has been completely torn and treatment is instituted more than a month after injury, surgery may involve using a tendon graft from the forearm to reconstruct the chronically injured, degenerated, and shortened ligament.


Thumb Ligament Injury can vary from mild to severe and prompt diagnosis and treatment will allow for quicker recovery. Call Dr. Pruzansky at 212-249-8700 to schedule an appointment.

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