Thumb Sprains
What are thumb sprains?
A sprain is an injury to a ligament. Ligaments are the connective
tissues that connect bones to bones across a joint.
How do thumb sprains occur?
These types of injuries are common in sports and falls. The thumb is
jammed into another player, the ground, or the ball. The thumb may be
bent in an extreme position, causing a sprain. The thumb will usually
swell and may show bruising. It is usually very painful to move.
What are the most common types of thumb sprains?
The most common ligament to be injured in the thumb is the ulnar
collateral ligament (see Figure 1). Injury to this ligament is sometimes
called “skier’s thumb” because it is a common skiing
injury. It occurs when the skier falls and the pole acts as a fulcrum in
the hand to bend the thumb in an extreme position (see Figure 2). This
ligament may also be injured by jamming the thumb on the ground when
falling or by jamming the thumb on a ball or other player. The radial
collateral ligament (see Figure 1) may also be injured. It is much less
commonly injured than the ulnar collateral ligament.
How are thumb sprains treated?
X-rays are usually taken to make sure the bones of the thumb and hand
are not fractured. Your doctor will then examine the thumb to determine
whether the ligament is torn. If the ligament is partially torn, it is
usually treated in a cast or splint. Radial collateral ligament injuries
are frequently treated this way as well. The end of a completely torn
ulnar collateral ligament often gets trapped behind a tendon. Complete
ulnar collateral ligament tears are most commonly treated with surgery
to repair the ligament. Sometimes the remaining ligament tissue is of
poor quality and the ligament must be reconstructed.
Chronic Injuries
The term “chronic” refers to an old injury of greater
than several weeks duration. In this case, the joint may be unstable
with symptoms of pain, especially with pinching. The joint may feel
loose and strength may be decreased. These injuries may be treated by
reconstruction of the ligament, or joint fusion if arthritis is
present.
Associated Injuries
On occasion, fractures may occur along with thumb sprains. These may
require additional surgery with repair using metal pins, screws, or
plates. Cartilage damage may occur as well which does not show up on
x-ray. This occasionally results in long-term pain and eventual
arthritis. Some patients may benefit from cortisone injections or
eventual surgery.
Figure 1: The ulnar collateral ligament (UCL) and
the radial collateral ligament (RCL) help stabilize the thumb.
Figure 2: Upon falling, the ski pole may bend the
thumb in an extreme position and tear the ulnar collateral ligament
(UCL), the so-called “skier’s thumb” injury.
© 2006 American Society for Surgery of the Hand
Developed by the ASSH Public Education Committee
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