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A sprain in the thumb usually occurs when the ligaments responsible for the movement of the thumb are stretched beyond their normal range of movement, resulting in injury or a tear. Most of the time, the sprain occurs when the thumb is bent backwards due to some strong force. 

There are two ligaments attached at the knuckle of the thumb that help in keeping the bone in a stabilized position. One is the radial collateral ligament, which is located on the outer side of the knuckle joint and the other is the ulnar collateral ligament, which is located on the inner side of the knuckle joint, towards the index finger. Most thumb sprains occur due to injury to the ulnar collateral ligament.

There are two injuries which are associated with damage or complete tear of the ulnar collateral ligament:

  • Skier’s injury: The ulnar collateral ligament rupture is the most common injury seen in skiers who fall on the ski slopes with their hand strapped to the ski pole.  
  • Gamekeeper’s thumb: This term was given to the Scottish gamekeepers in the year 1955 who used to kill the rabbits by strangling them with their thumb and index finger. The continuous strain to the ulnar collateral ligament caused permanent instability of the thumb.

A sprain is painful and makes the thumb feel unstable and weak. A sprained thumb can be treated by wearing a crepe bandage, splint or cast which restricts the movement of the affected part. Some severe sprains are stabilised with the help of surgeries. 

  1. Types of a sprained thumb
  2. Symptoms of a sprained thumb
  3. Causes of a sprained thumb
  4. Prevention of a sprained thumb
  5. Diagnosis of a sprained thumb
  6. Treatment of a sprained thumb
Doctors for Sprained thumb

The thumb sprain can be divided into three grades depending upon the severity of the sprain:

  • Grade 1 sprain: The sprain is mild as in this grade as the ligaments are stretched but intact.
  • Grade 2 sprain: This sprain is moderate as the ligaments are torn but only partially. The person might not be able to move his/her thumb at this point.
  • Grade 3 sprain: The sprain is severe as the ligament is either pulled off the bone or is completely torn. These sprains require surgical care. Sometimes in these sprains, while tearing off, the ligament takes away a chipped part of the bone with it, which is then called an avulsion fracture. 

The symptoms of a sprained thumb are:

  • Thumb pain
  • Pain in the surrounded area
  • Bruising of the thumb
  • Swelling of the thumb joint and palm
  • Inability to write or hold anything with the help of the thumb

Thumb sprains can be the result of a sudden and strong force being exerted on the area, that stretches or detaches the ligaments of the thumb. This could happen during a fall or an accident. 

This injury is mostly seen in athletes, skiers and people who are involved in sports like football, volleyball, basketball, judo and netball.

Thumb sprain is mostly the result of an accidental injury, therefore there is no specific prevention to it. Though, if you are playing a sport which allows you to wear protective gear like gloves and guards, please do so to prevent the spraining of your thumb.

Skiers should wear the right-sized protective gloves which might prevent thumb injury in case of a fall.

Your doctor may ask you a couple of questions about the incidence, the pain and the beginning of the swelling in order to make a correct diagnosis.

Your doctor will also do a physical examination of the thumb to know the extent of the condition. For instance, on moving the thumb, if the joint looks completely loose and unstable then it means that the ulnar collateral ligament has torn off completely.

X-rays can be advised by the doctor to check for avulsion fractures.

The treatment begins with RICE or rest, ice, compression, and elevation therapy. 

  • Rest should be given to the injured hand. Restrict the movement of the hand by taping the thumb in place, to the rest of the hand.
  • Ice application should be done for the first 24 to 48 hours in order to reduce the inflammation and swelling. Direct application of ice to the injury site can be done. 
  • A compression bandage or thumb splints should be used to support the joint. This would not only support your thumb but also help in reducing the swelling.
  • Elevation of the injured site with a more appropriate thumb spica cast could also be done to prevent the back bending of the thumb. 

If the ligament is partially torn, it takes 2-3 weeks for the ligament to heal and the thumb to regain its full range of motion.

In case of a complete tear of the ligament, surgery is done to reattach the ligament to the bone. In the case of avulsion fractures, the surgery involves reattaching the bone and ligament with the help of pins, screws or bone anchors. 

Dr. Tushar Verma

Dr. Tushar Verma

Orthopedics
5 Years of Experience

Dr. Urmish Donga

Dr. Urmish Donga

Orthopedics
5 Years of Experience

Dr. Sunil Kumar Yadav

Dr. Sunil Kumar Yadav

Orthopedics
3 Years of Experience

Dr. Deep Chakraborty

Dr. Deep Chakraborty

Orthopedics
10 Years of Experience

References

  1. The British Society for the Surgery of the Hand [Internet]. Journal of Hand Surgery European Volume. London. UK; Skier's thumb
  2. National Health Service [Internet]. UK; Sprains and strains
  3. Orthoinfo [internet]. American Academy of Orthopaedic Surgeons, Rosemont IL. Sprained Thumb
  4. American Society for Surgery of the Hand [Internet]. Chicago, USA; Thumb Sprains
  5. Royal Berkshire. NHS Foundation trust. National Health Service, U.K. Thumb injury
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