Examination of the collateral ligaments of the thumb

23 Sep

Gamekeeper’s thumb or skier’s thumb -> injury to ulnar collateral ligament (UCL) of the metacarpophalangeal (MCP) joint

 

  • due to forceful abduction and hyperextension
  • clinical presentation of pain at the base of thumb
  • stabilize the MCP joint, then apply a valgus force (radially deviating the thumb) while positioned in flexion and extension
    • In 30-40 degrees flexion, the “proper” UCL can be assessed for laxity
    • In extension, the “accessory” UCL can be assessed for laxity
    • To test for a completed UCL tear, you must examine both the proper and accessory components
  • If in doubt, place a thumb spica splint and refer to a hand specialist

 UCL

 

Submitted by K Estes.

 

Source: EM:Rap (text and photo)

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