Ulnar Collateral Ligament Repair of Thumb
What is the Ulnar Collateral Ligament?
The ulnar collateral ligament is a strong band that is attached to the middle joint of the thumb (metacarpophalangeal joint). Injury to this ligament is also known as Gamekeeper’s Thumb, because Scottish gamekeepers used to commonly have this type of injury as a result of their jobs; and more commonly today as Skier’s Thumb, because it occurs so often in downhill skiing accidents. Injury to this ligament is commonly due to any hard force put on that thumb that causes the thumb to be pulled away from the palm of the hand, usually a result of a sports related injury. This force can result in a partial tear of the UCL (ulnar collateral ligament) or a complete tear of the UCL, known as a rupture. A tear to the UCL results in the MCP (metacarpophalangeal) joint of the thumb becoming very unstable and painful. The most common symptoms associated with UCL injuries are swollen, painful joint, and weakness to thumb especially with gripping or pinching, as well as bruising.
Surgery:
To repair the UCL ligament of the thumb involves reattaching the torn ligament, usually with internal sutures. This surgery takes approximately 1 hour, and is performed as an outpatient surgery, meaning you will be able to go home that day.
Things to know:
- You will be discharged in a temporary splint that must be kept clean and dry until you are seen for follow up.
- You will follow up with us in the office 1-2 days after the procedure. You will be sent for a custom splint that is removable for showering ONLY.
- After 48 hours you may shower. While showering, you may use soap and water, but be sure to pat the incision dry. It is important that you do not submerge your surgical incision in water (i.e. no bath tubs, swimming pools, washing dishes, etc.). While showering, it is important you do not use your hand/arm. After showering, pat incision dry and replace splint.
- It is important to elevate your arm on a couple of pillows to alleviate pain and swelling.
- We do encourage you to move your unaffected fingers while wearing the splint.
- Sutures will remain in place for 10-14 days.
- Typically follow up appointments are scheduled in two-week intervals following surgery, so we can monitor your recovery.
- You will wear your splint at all times for 6 weeks. After 6 weeks, you will be referred for Occupational Therapy of the affected hand and wrist.
- The splint will gradually be discontinued in the weeks to follow as you progress with occupational therapy. Your lifting restrictions will gradually be increased over the next 2-3 months.
Postoperative restrictions are as follows:
- NO use of the affected hand.
- Must wear splint at all times, except while showering.