Gamekeeper's thumb
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Gamekeeper's thumb (also known as skier's thumb or UCL tear) is a type of injury to the ulnar collateral ligament common among gamekeepers, especially Scottish fowl-hunters. The hunter would carry home their game with a leather throng attached to their thumb draped over their shoulder. Other sources cite the fact that English gamekeepers sustained the injury because they killed rabbits with a forceful blow from their thumb web space to the back of the animals' necks. Skiers have also reported similar problems caused by gripping their ski poles when falling, causing stress on the UCL. The injury is also common in sports players (forced abduction of the thumb) and in persons who have sustained a fall.
Symptoms and Treatments
Some of the symptoms of Gamekeeper's Thumb are a weakened ability to hold objects, decreased thumb stability (catching the thumb in objects, etc.), local swelling, local pain, and ecchymosis. This particular injury is clinically noteworthy because the ulnar collateral ligament is an important stabilizer of the thumb, and also because the adductor pollicis tendon may at some point insert itself between the bone (metacarpo-phalangian or MP joint) and the torn ligament, thus preventing the healing process. The severity of the symptoms are dependent on how long the injury has been allowed to progress. Usually, Gamekeeper's Thumb can be treated without surgery by simply letting the ligament heal, but near total or total tears of the ligament must be fixed with surgery. If surgery is not needed, a thumb cast or a modified wrist splint is used to keep the thumb immobile so that the ligament can heal.
Differences between Gamekeeper's Thumb and Skier's Thumb
Gamekeepers's Thumb and Skier's Thumb are essentially the same, and can be used interchangeably. However, Skier's Thumb is considered to be more acute, as skiers only acquire the injury after falling. Gamekeepers acquire the injury over time as the result of their job. Skier's thumb is more easily treated because the injury has not exacerbated itself yet, as opposed to Gamekeeper's thumb.
