Thursday, April 18, 2024

Torn Ligament In Thumb Surgery

What Are The Different Types Of Thumb Sprains

Surgical Repair of Ulnar Collateral Ligament of Thumb

Healthcare professionals use a grading system to classify the severity of sprains. The three different grades include:

  • Grade 1: A grade 1 thumb sprain is a mild sprain. The affected ligament is overstretched but not torn.
  • Grade 2: A grade 2 thumb sprain is a moderate sprain. The affected ligament is partially torn.
  • Grade 3: A grade 3 thumb sprain is a severe sprain. The affected ligament is completely torn or separated from its attachment to your bone. Severe sprains require medical and/or surgical care.

How Long Does The Pain Of A Sprained Thumb Last

A mild thumb sprain is commonly caused by repetitive motions. Most of the time, it is not painful and is often ignored. However, if adequate rest is not provided and repetitive movements are continued, it may progress to a moderate to severe sprain.

A moderate thumb sprain takes a longer time to heal than a mild injury. There is some discomfort and difficulty in moving the thumb. This may persist for a few days to a few weeks. Normal thumb movement may return within 6 weeks.

A severe thumb sprain can be extremely painful. You may need to have an X-ray to check for a presence of fractures. It usually requires surgery to repair the torn ligament. You may experience pain for a few weeks but this can be managed with prescribed pain medications.

If pain is persistent and does not get better with rest, ice, and pain medications within 3 days, seek the advice of your doctor immediately.

How Is A Ucl Injury Treated

The treatment depends on the severity of the injury. Grade 1 and 2 injuries are treated by splinting, generally for eight weeks. Grade 3 injuries are most commonly treated with surgery. In all instances you will be referred to a hand therapist as part of your treatment for splinting, education and rehabilitation.

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How Can Dr Knight Help You With Gamekeepers Thumb

Working in sports medicine, Dr. Knight is very familiar with this type of injury and is well versed in its treatment. Upon ascertaining the severity of your case, he will proceed in the manner most appropriate to bring your hand back to full use.

We looking forward to helping you live a more pain free life. Dr. Knight is one of the top hand doctors in Dallas. Visit Dr. John Knight at our Southlake hand and wrist center or Dallas office location.

Recovery Process From A Ligament Tear

Unraveling the UCL Injury of the Thumb

Ligament tears are common when performing in sports or just when stepping awkwardly. These injuries occur when an individuals joint is stretched out beyond the normal range, causing the ligament to partially or fully tear.

If the ligament is only partially torn, you will likely be told by your doctor to follow the RICE method: rest, ice, compression, and elevation of your joint that was affected. However, if it is fully torn, you may need to have surgery to repair the ligament tear.

Although surgery to fix a torn ligament is usually performed as an outpatient procedure, the recovery process will take a while. You will likely undergo rehabilitation for about six months, but the length of time will depend on the severity of your injury.

Below is the general timeline and what you can expect during ligament tear recovery.

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Remaining Comfortable During Recovery

As the swelling and pain subside, return to normal activities slowly. Doing too much too quickly can aggravate the injury.

Strengthening exercises may help the thumb to heal, but the correct exercise will depend on the injured ligament. Consult a doctor or physical therapist who can recommend what exercise to do, when to begin it, and how frequently to perform it.

When the thumb has been stretched too far or otherwise damaged, the injury will likely be a sprain. However, symptoms can take time to appear, so it may be difficult to distinguish the sprain from other injuries. Pain from these other injuries may also radiate throughout the thumb, worsening the pain from the sprain.

Changes in the shape of the thumb, a cracking sound following a fall, and numbness often occur when the thumb or a nearby bone is broken.

A doctor can perform an X-ray to ensure that there are no broken bones. This can also help to determine whether a condition such as arthritis is causing the symptoms.

Common symptoms of a sprain include:

  • pain that radiates throughout the hand or wrist
  • bruising, swelling, or discoloration around the thumb
  • looseness in the joint or trouble moving the thumb

Doctors judge the severity of a sprain using a grading system:

Below is a 3-D model of a sprained thumb, which is fully interactive.

Explore the model using your mouse pad or touchscreen to understand more about a sprained thumb.

Grades Of Thumb Sprains

Sprains are graded based on the degree of injury to the ligament:

  • Grade 1 sprain . The ligament is stretched, but not torn.
  • Grade 2 sprain . The ligament is partially torn. This type of injury may involve some loss of function.
  • Grade 3 sprain . The ligament is completely torn in the middle or is pulled off its attachment to the bone. These are significant injuries that require medical or surgical care. If the ligament tears away from the bone, it may take a small chip of the bone with it. This is called an avulsion fracture.

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What Are The Possible Complications

The most common complications or side effects of surgery are of temporary alteration in sensation of the skin around the site of the surgical incision, and of stiffness of the joint. These problems generally resolve with time. It is also possible that you could have ongoing discomfort, instability or pain anaesthetic complications scar tenderness or hypersensitivity a need for further surgery failure of the surgery to resolve the presenting symptoms troubles with unsightly skin scarring joint damage related to delayed diagnosis and treatment infection temporary bruising.

How Is A Sprained Thumb Diagnosed

Thumb UCL Repair With InternalBrace Ligament Augmentation Procedure

Your healthcare provider will ask you questions about how and when you injured your thumb and about your symptoms. Theyll then perform a physical exam to assess the stability of your thumb joint and where the pain is coming from to determine if the injury is or isnt a sprain and how severe the injury is. They may also have you undergo imaging tests as mentioned above.

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Description Of The Intervention

UCL injuries can be treated surgically or nonsurgically. Nonsurgical or conservative options include plaster or splint immobilization . Typically, the MCP joint is immobilized in the position of mild flexion and slight ulnar deviation at the MCP joint for four to six weeks. This positioning brings the torn ligament fragments closer, thus facilitating healing. A variety of plaster casts and splints are described in the literature. The standard thumb spica cast consists of layers of plaster of Paris or fibreglass molded over and enclosing the thumb, wrist and forearm. Other casts described in the literature include a modified thumb spica cast allowing removal and wrist motion , and a glove spica cast reported as enabling immediate return to activities or sports .

Unlike casts, splints are noncircumferential immobilizers that can accommodate swelling. The thumb spica splint consists of either a fabric enclosing a moderately pliable metal piece along the part that supports the thumb, or fiberglass/thermoplastic that can be cut and molded accordingly. Prefabricated and overthecounter splints are also available. The splints may have adjustable straps to make them fit snugly around the thumb as well as the forearm. Immobilization is followed by physiotherapy, which includes joint mobilization followed by strengthening exercises.

Thumb Ucl Injuries In Athletes Clayton E Nelson Md

Every season we hear of elite athletes sidelined because of injuries to their hand. Last year Drew Brees and Steph Curry were atop the headlines for notable athletes sentenced to the disabled list while their hands recovered. Although there are many types of hand injuries among athletes, the hand in general is a common site of injury during sports because of its exposed nature and tendency to absorb initial contact. Among injuries to the hand, trauma to the thumb is an all too common site of injury for the competitive athlete.

Whether you are throwing a football or swinging a bat, the thumb is an important stabilizer for pinch and grip activities required by many athletes. The most common athletic injury sustained to the thumb is an injury to the ulnar collateral ligament or frequently called the thumb UCL.

A ligament is a soft tissue structure that connects bones to each other at joints. The thumb ulnar collateral ligament helps connect the thumb to the hand on the side near the index finger at the metacarpophalangeal joint. It functions to allow the thumb to act like a post to stabilize the thumb and aid in pinch and grip.

The UCL tends to be injured when the thumb is pulled in an extreme position away from the hand. This is frequently from contact with another player, the ground, or a ball. An athlete who sustains an injured UCL will have pain, swelling and most notably weakness with grip.

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What Causes A Sprained Thumb

A thumb sprain can happen from a sudden, strong force that bends your thumb backward, away from your palm, or in another awkward direction. This often happens from falling on your outstretched hand. A thumb sprain is also a common skiing injury from falling with the ski pole still in your hand, which is why thumb sprains are sometimes called skiers thumb.

A thumb sprain can also happen over time from activities or sports that involve repetitive grasping or hand twisting. This type of thumb sprain is considered chronic and is known as gamekeepers thumb.

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MRI NEWSLETTER: Ulnar Collateral Ligament Injury

You can imagine if youre skiing down a mountain and your ski pole gets planted and your thumb gets violently bent away from the hand, thats how this ligament gets torn, said Dr. Clay Nelson, a surgeon with Oklahoma Sports and Orthopedics Institute, who did not treat Sanders, but specializes in hand and upper extremity injuries.

It can happen in any ball sport or to any athlete where the thumb gets bent into an extreme position away from the hand, because the job of that ligament is to connect that joint and keep it stable. But when it gets pulled too far, it gets injured.

The internal brace, which uses a high-strength, braided suture material, doesnt allow the ligament to heal any faster, Nelson said. It allows for a shorter rehab, because it stabilizes and protects the ligament while the ligament heals. The ligament takes 10-12 weeks to fully heal, but some of these athletes are getting back to play as soon as 5-6 weeks.

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Who Is At Risk For A Sprained Thumb

Anyone can get a sprained thumb at any age, but people who ski or who play sports that involve a ball and using your hands, such as baseball, basketball, volleyball and football, are more likely to get a sprained thumb. People who are at a higher risk of falling are also more likely to get a sprained thumb.

What Is The Recovery Time

UCL repair surgery is an outpatient procedure and patients go home the same day. Most wear a soft splint for the first week and then spend four to six weeks in a cast to allow the ligament to heal. Rehabilitation with a certified hand therapist helps regain strength and stability. Patients generally return to daily activities and work within a few weeks, often with a splint to avoid stressing the UCL too much. Return to sports usually takes about three to four months.

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Injury To The Ulnar Collateral Ligament Of The Thumb

The ulnar collateral ligament of the thumb is a strong band of tissue running along the inside of the metacarpophalangeal joint, which is where the thumb meets the palm. This ligament keeps your thumb stable, especially when you pinch and grasp things.

A thumb UCL injury is commonly called skiers thumb, because falling on the ski slopes with your hand strapped to a ski pole is a common cause of this injury.

The ligament can also be injured more gradually, over time, from repetitive grasping or twisting activities. This type of chronic injury is known as gamekeepers thumb” because originally, it was most commonly a work-related injury seen among Scottish gamekeepers .

The ulnar collateral ligament can tear in different ways. For example, it may be:

  • Pulled off its attachment at the base of the first bone in the thumb
  • Pulled off the metacarpal bone, where it originates
  • Torn through its middle, though this is less common

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Ulnar Collateral Ligament Repair Surgery

Torn thumb ligament before and after repair

UCL repair surgery is a procedure to treat an injury to the UCL, the soft tissue that connects the bones of the thumb and provides stability to the thumb joint. In this minimally invasive technique, the surgeon makes a small cut over the back of the thumb joint and examines the area around the injury for damage. The surgeon then reattaches the UCL and uses a suture anchor or screw to hold it in place as it heals.

Surgery is most effective when performed within the first few weeks following injury. Untreated, UCL injuries can lead to chronic pain and instability, diminished hand function and early onset arthritis.

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Does A Torn Ligament In Your Thumb Require Surgery

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Can Finger Tendons Heal Without Surgery

If your flexor tendons are damaged, youll be unable to bend one or more fingers. Tendon damage can also cause pain and inflammation in your hand. In some cases, damage to the extensor tendons can be treated without the need for surgery, using a rigid support called a splint thats worn around the hand.

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Where Ligament Tears Are Most Common

  • Ankle:Ligament tears are most common toward the outer side of your ankle at what’s called the lateral ligament complex. It includes the anterior talofibular , the calcaneofibular , and posterior talofibular ligaments. The medial deltoid ligament, toward the inside, is injured less often. A high ankle sprain is more often seen in competitive athletes.
  • Knee:The four major knee ligaments are the anterior cruciate ligament , posterior cruciate ligament , medial collateral ligament , and lateral collateral ligament . The ACL tear is the most common of these injuries.
  • Wrist:There are 20 ligaments in the wrist. Tears will most often occur when you fall on an outstretched hand. The scapholunate and the triangular fibrocartilage complex are the most common ones injured.

Other common sites of ligament tears and the possible causes behind them include:

  • Thumb:The ulnar collateral ligament can be torn when skiing or in a fall when the thumb is bent in an extreme position.
  • Neck:The neck’s ligaments can be torn during whiplash injuries, as in a car accident. The hard speed-and-stop is an extreme motion that injures the cervical spine, the part of the spine in the neck. The ligament tear is just one part of a whiplash injury. It may also damage muscles, nerves, and bones.
  • Back:The ligaments in your back can be torn by lifting something that is too heavy.

Is My Thumb Broken Or Sprained

Tore a ligament in my hand/thumb

Both a broken thumb and a sprained thumb can cause pain, swelling and bruising, but there are some differences to look for. A broken thumb usually causes more intense pain, and your thumb may look deformed or misshapen. A broken thumb can also cause numbness or tingling. If youre experiencing pain, bruising and swelling in your thumb after an accident such as a fall, be sure to contact your healthcare provider. It can be difficult to tell from the outside if your injured thumb is broken or sprained, so its important to get an X-ray and an exam from a knowledgeable healthcare provider to know for sure what the injury is.

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Ulnar Collateral Ligament Injury Of The Thumb

Hand surgery, orthopedics

Gamekeeper’s thumb is a type of injury to the ulnar collateral ligament of the thumb. The UCL may be merely stretched, or it may be torn from its insertion site into the proximalphalanx of the thumb in approximately 90% of cases part of the bone is actually avulsed from the joint. This condition is commonly observed among gamekeepers and Scottishfowl hunters, as well as athletes ” rel=”nofollow”> goalkeepers). It also occurs among people who sustain a fall onto an outstretched hand while holding a rod, frequently skiers grasping ski poles.

How Long Does It Take For A Sprained Thumb To Heal

The length of recovery for a sprained thumb depends on the severity of your sprain. A mild sprain usually heals within four to six weeks if you wear a splint or cast to immobilize your thumb and refrain from activities that irritate it.

A more severe thumb sprain, such as a grade 3 sprain, could take several months before its fully healed and youre able to use your thumb like normal again. This is because severe sprains usually require surgery, which then requires you to wear a post-surgery splint or cast and do physical therapy.

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