• Ulnar collateral ligament injury of the thumb


    Ulnar collateral ligament injury of the thumb involves stretching and tearing of a ligament at the base of the thumb (ulnar collateral ligament [UCL]). This ligament is important in the function of the thumb, particularly when you grab, grasp, or pinch (such as when holding your keys). Sprains are classified into three grades. In a first-degree sprain, the ligament is not lengthened but is painful. With a second-degree sprain, the ligament is stretched and painful but still functions. With a third-degree sprain, the ligament is torn and does not function.

    Common signs and symptoms

    • Pain, tenderness, bruising, swelling and redness at the base of the thumb, starting at the side of injury, that may progress to the whole thumb and even hand with time
    • Impaired ability to grasp or hold things soon after injury

    Treatment considerations

    Initial treatment consists of ice to relieve the pain and compressive elastic bandaging and elevation to help reduce swelling and discomfort. A brace or cast may be recommended to provide support to the joint for varying times, depending on severity of injury. For complete tears of the ligament, surgery is often recommended because other tissues may become entrapped between the ends of the ligament, preventing healing.

    RICE Principle  

    With all acute injuries, follow the RICE principle to reduce swelling, pain and inflammation.

    R est- Use that hand sparingly if possible.

    I ce- Use an ice pack for 20 minutes every two to three hours during the first 72 hours.

    C ompression- Use an ace wrap if needed. Start at the top of the thumb and then wrap around the hand and wrist.

    E levation- Keep the injured hand above the level of the heart when you are sitting or lying down

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