Dr. Mark E. Pruzansky
Dr. Jason S. Pruzansky
975 Park Avenue New York, NY 10028

Thumb Ligament Injury

Thumb Ligament Injury 1

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

What is a Thumb Ligament Injury?

A thumb ligament injury generally involves one of the collateral ligaments of the thumb metacarpophalangeal joint, where the thumb meets the palm. Common names for associated thumb injuries include Skier’s Thumb and Gamekeeper’s Thumb, as well as injuries to the collateral ligament on the side of the thumb joint closer to the index finger.

Characteristics and Clinical Presentation

Patients may present with pain, swelling and ecchymosis following a blow to the thumb, which may force it into hyperextension or radial deviation. Patients may also complain of worsening pain in addition to weakness when pinching the thumb against the index finger. An acute injury may not be present.

Pain may be intermittent, leading patients to believe the injury resolved on its own. However, you should always see a doctor at the first sign of pain or instability to make sure you have the best chance of getting the right diagnosis and treatment plan to help you long-term.

Some of the most commonly reported symptoms of thumb ligament injuries include:

  • Point tenderness.
  • Ecchymosis
  • Swelling

Causes of Thumb Ligament Injuries

Any strong force that bends the thumb backward has the potential to cause a thumb ligament injury.

Thumb Ligament Injury 2

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

Injuries may be sustained from falling onto a ski pole while skiing when strapped into the device. Thumb ligament injuries may also be a result of chronic overuse, resulting from repetitive grasping movements or twisting.

Diagnosis for Thumb Ligament Injuries

X-rays or MRIs may be ordered if the injury is difficult to diagnose or if more serious complications occur.

Standard radiographs should be obtained before lateral stress examination.

Treatment Options for Thumb Ligament Injuries

Rest your hand following an injury and cease strenuous activity until you are cleared by your doctor. Surgical intervention may be required in severe cases. The R.I.C.E method is also helpful:

  • Rest : avoid using your elbow while it is healing.
  • Ice : use an ice pack for 15-20 minutes a day.
  • Compression : compression bandages can help reduce swelling.
  • Elevation : keep your elbow above your heart to reduce swelling.

Conservative Treatments for Thumb Ligament Injuries

Ice should be applied immediately after an injury occurs. Splinting may avoid the additional pain from movement that occurs with this type of injury. Nonsteroidal anti-inflammatory (NSAIDs) may reduce pain and swelling.

Thumb Ligament Injury 3

Ulnar collateral ligament thumb metacarpophalangeal joint rupture and Stener lesion

A brief course of narcotics may be warranted to alleviate the acute phase of pain.

Surgical Treatments for Thumb Ligament Injuries

Gamekeeper’s thumb injuries may or may not require surgical intervention. This decision is will be made by Dr. Mark Pruzansky or Dr. Jason Pruzansky to maximize your outcomes.

The emergency medicine physician should immobilize all suspected injuries in a thumb Spica splint and have the patient follow up within 1 week.

Surgical measures involve reconnecting the damaged ligament to the bone and/or repairing the damaged avulsion fracture with a pin, screw, or a bone anchor.


Patients recovering from surgical intervention may be required to wear a hand cast or a splint for 6-12 weeks following their procedure. When properly diagnosed and treated, many patients can look forward to improved function and mobility in their thumb with no complications.

This is why HandSport Surgery Institute always recommends that patients see a specialist as soon as possible following an injury or new pain.

If You Believe You Have a Thumb Ligament Injury, Contact HandSport Surgery Institute

Please contact us as soon as possible to schedule an appointment with our talented team. People experiencing a potential thumb ligament injury should be evaluated to try and reduce the risk of further injury and mobility issues.

If you have been injured, it’s important to be evaluated by a highly skilled professional. Call Dr. Mark Pruzansky and Dr. Jason Pruzansky at 212-249-8700 to schedule an appointment, obtain an accurate diagnosis, and start to improve the function of your hand.