- Thumb ulnar collateral ligament (UCL) tear
- Thumb UCL sprain
- Skier’s thumb
- Breakdancer’s thumb
- 842.12 Sprains and strains of metacarpophalangeal (joint)
- S63.659 A Sprain of metacarpophalangeal joint of unspecified
finger, initial encounter
- S63.649 A Sprain of metacarpophalangeal joint of unspecified
thumb, initial encounter
- Gamekeeper’s thumb is ligamentous disruption
of the UCL of the first MCP joint due to acute or repeated valgus
stress to the thumb.
- Presents as instability and/or pain with valgus forces
to the thumb or pain and weakness with opposition or pinching.
- Tenderness or swelling may be present at medial aspect of
- Valgus stress to the UCL of the first MCP will
result in asymmetric laxity compared to uninvolved side or lack
of an end point.
- Injury can be either acute or chronic and is common in
athletics (especially skiing and football).
- Injury involves valgus force to the proximal phalanx of the
- Injury can also involve an avulsion fracture of the base of
the proximal phalanx, which is termed “gamekeeper’s
- Plain film radiographs are beneficial to rule out fracture.
- Manage surgically or non-surgically depending upon severity
of signs and symptoms and orthopedic physician recommendations
- Common in athletes, typically involving a fall (football),
impact from a ball (basketball), or repeated stress (skiing)
- Seen in fowl hunters
- Pain over medial MCP joint
- Palpable tenderness and possible swelling over medial MCP
joint line/UCL of thumb
- Instability and/or pain with valgus stress to MCP
- Weakness with pinching or opposition
- Repeat subluxation of the MCP resulting in medial angulation
of the proximal phalanx with valgus stress or force
- Difficulty and/or pain when grasping dishes,
utensils, or drinking cups due to pain and weakness
- Difficulty and/or pain when grasping and turning
- Difficulty and/or pain when turning doorknob
- Participation in activities or sporting events that involve
repeated valgus stress to proximal phalanx in thumb
- Participation in contact sports
- Generalized ligamentous laxity
- Gamekeeper’s fracture
- Fracture of the base of the first metacarpal bone (Bennett’s
- Distal metacarpal fracture
- Proximal phalanx fracture
- Extensor tendon rupture (boutonnière deformity)
- Valgus stress test to the proximal ...
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