Thumb ulnar collateral ligament injuries

Anatomy

The collection of soft tissue called the thumb ulnar collateral ligament ensures the finger continually maintains the strength and stability needed to perform almost every important function your hands and fingers routinely carry out. This ligament is situated at the thumb’s base and prevents the finger from overextending away from your hand.

The important ligament is further divided into two supporting structures called the UCL proper and the accessory UCL. Injury or damage to either one can result in pain, immobility, and disability.

Causes

A UCL injury typically occurs when you plate acute increased or chronic consistent pressure on your thumb. Such actions can stretch or tear the ligament.

Symptoms

The most common symptom is pain. Besides discomfort, you might witness redness and swelling in the affected thumb. You will likely encounter significant difficulties gripping or lifting objects. Additionally, your thumb might feel loose, unstable, and hard to move.

Thumb ulnar collateral ligament (UCL) injury symptoms:

• Pain
• Discomfort
• Redness
• Swelling
• Difficulty gripping or lifting objects
• Your thumb feels loose, unstable, and hard to move

Complications

If left unchecked, ligament damage can progress, be more challenging to treat, and possibly lead to permanent thumb deformity and pain.

Diagnosis

Your doctor will first do a physical evaluation of your thumb, besides asking you when the injury occurred and the symptoms you have experienced since the event happened.

Usually, confirmation happens after examining the results of one or more internal imaging tests like an X-ray or an MRI scan (magnetic resonance imaging).

Treatment

More severe injuries typically need more aggressive treatment. Your doctor will determine the most appropriate treatment plan after considering other factors such as your age, the length of time that has passed since the injury occurred, and how physically active you are.

Nonsurgical treatments

Mild to moderate events in which ligament tears are minor, and the affected thumb still enjoys relative stability, are often placed inside a movement-restricting device like a splint or cast for a healing period lasting anywhere from four to six weeks.

Surgical options

If your UCL is severely or completely torn, has caused noticeable thumb instability, or has led to a chronic weakening of your thumb, you may be a candidate for corrective surgical procedures. The type of operation performed will depend on the injury’s extent.

When partial ligament tears occur, a surgeon can sew separated ends back together. Surgery to repair chronic cases often needs reconstruction of the UCL using soft tissues found in other parts of the hand or body.

Surgery is usually followed by physical therapy. When undergoing physical therapy, you perform exercises intended to help keep the thumb mobile and strong.

Recovery

The duration of your recovery depends on several things, including how bad the UCL injury was, and the specific treatment used. On average, you will likely be able to return to normal daily activities and competitive sports in three to four months.

Prevention

Typically, prevention is challenging as many thumb ulnar collateral ligament tears occur immediately following acute trauma brought forth by a fall, accident, or excessive contact in athletic competitions.

You can reduce your risk by engaging in proactive efforts like remembering to release a ski pole when tumbling during a downhill run and not driving with your thumbs inside the steering wheel.

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