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Wheeless' Textbook of Orthopaedics

Rheumatoid Gamekeeper's Thumb





- See: Traumatic Gamekeeper's Thumb:

- Discussion:
- characterized by abduction deformity of MCP joint;
- results from attenuation of ulnar collateral ligament;
- there is also an adduction contracture of the metacarpal;
- Exam:
- stability of the MCP joint should be tested by applying an ulnarly
      directed force to joint, both w/ joint extended and flexed;
- joint should be tighter in flexion than extension;
- compare injured joint to the contralateral normal joint;
- Treatment:
- requires ulnar collateral ligament repair;

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Gamekeeper's thumb. Evaluation by arthrography and stress roentgenography.

Instability of the metacarpophalangeal joint of the thumb. Reconstruction of the
    collateral ligaments using the extensor pollicis brevis tendon.

Stener B: Displacement of the ruptured ulnar collateral ligament of the
  metacarpophalangeal joint of the thumb:   A clinical and anatomical
  study.   J Bone Joint Surg 1962;44B:869-879.

Carr D, Johnson RJ, Pope MH: Upper extremity injuries in skiing.   Am J
  Sports Med 1981;9:378-383.

Mogan JV, Davis PH: Upper extremity injuries in skiing.   Clin Sports Med
  1982;1:295-308.



Original Text by Clifford R. Wheeless, III, MD.