Thumb ligament injuries

The thumb knuckle joint (the metacarpophalangeal joint) is supported by two important ligaments, the radial and ulnar collateral ligaments. These are commonly injured in sports injuries such as playing rugby, netball or skiing and snowboarding. The ulnar collateral ligament is particularly important in helping the thumb act as a post to support pinch grip. If this ligament ruptures, it may become stuck in the muscle underneath it. When that happens it usually won’t repair itself, and the thumb can become weak and buckle with time. This can cause patients to drop things, and lose the function of their thumb.

Mr Wharton offers expert assessment and investigation of thumb ligament injuries. This often requires an ultrasound or an MRI scan. Once the diagnosis is confirmed, a splint can be applied for sprains; or surgery may be recommended for a full thickness rupture. The surgery is performed as a day case under general or regional (nerve block around the shoulder) or local anaesthetic. The detached ligament is freshened up, and pulled back down onto the bone using a bone anchor. For injuries that are older the ligament may have shortened, and a reinforcement or reconstruction might be necessary using an artificial ligament made of very strong suture material, or even using a tendon graft from the front of the wrist. After the surgery a plaster cast is usually applied for a couple of weeks, and a protective splint is recommended which can be removed for gentle exercises. The patient should elevate their hand for at least five days, and keep the wound dry for at least two weeks.