May 30, 2017
- The thumb MCP (metacarpophalangeal) joint is where the thumb connects to the hand. On the inside of this joint, in the first web space, there is a ligament called the ulnar collateral ligament (UCL). This ligament stabilizes the thumb joint from laterally applied (side) forces during any activities that involve gripping, such as holding a baseball bat.
- The ligament typically tears during an injury, when the thumb is forcibly pulled away from the hand. This mechanism commonly occurs during skiing injuries, and thus this injury is referred to as “skier’s thumb.”
- When only part of the ligament tears and some fibers remain intact, treatment usually involves splinting or casting to allow the torn fibers to heal. When the entire ligament tears, it usually pulls off of the bone. The thumb then becomes “loose,” and surgery is required to reattach the ligament back to the bone to reestablish joint stability.
- Ligament healing requires approximately 6-8 weeks, during which time patients can undergo therapy to ensure that their thumb is moving and the tendons are gliding properly. Ultimately, whether by immobilization with partial tears or surgery with complete tears, the thumb typically recovers fully and future function and return to sport are expected
Dr. Cohen is a team physician and consultant for the Chicago White Sox and the Chicago Bulls.