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We present a representative case of a professional basketball player treated with this novel procedure. After the surgical repair, the patient was placed in a plaster splint for 3 days to immobilize the thumb and wrist. At 3 days postsurgery, the splint was removed and therapy initiated. Practice drills were initiated at 1 week postsurgery with the use of a removable hand-based thumb spica custom splint. During the entire postoperative period, the left thumb MCP joint had excellent stability to radial stress at full extension and 30 degrees of flexion. In addition, at 3 weeks postsurgery, the patient was able to oppose the thumb tip to the palmar-digital crease of the small finger and MCP joint motion was 0 to 50 degrees.
The splint should be worn at all times, expect when showering. You are able to shower 48 hours after surgery; however, it is important that you do not submerge your surgical incision in water i. When showering, it is important you do not use the affected hand. After showering you may pat incision dry and replace the splint. Sutures will be removed days after surgery. After suture removal, you will continue to wear your splint for about 6 weeks, and then only at night for 2 additional weeks.
Your follow up appointments will be about every 2 weeks to monitor your recovery. When a skier falls down while holding a ski pole, the thumb may get bent out and back, leading to an injury in the ulnar collateral ligament of the thumb. Symptoms What does an injured ulnar collateral ligament of the thumb feel like? When the ulnar collateral ligament of the thumb is injured, the MCP joint becomes painful and swollen, and the thumb feels weak when you pinch or grasp. You may see bruise-like discolorations on the skin around the joint.
The loose end of the torn ligament may form a bump that can be felt along the edge of the thumb near the palm of the hand.
This may feel numbness on the back of the bounty. Steal keeps the joint from important, but it also claims it from again becoming arthritic and engaging.
A torn ligament makes it difficult to hold or squeeze things between your thumb and index finger. We will also do a complete physical exam of both thumbs and hands. Some patients may be referred to a doctor for further diagnosis. Once your diagnostic examination is complete, the Physical Therapists at Peak Performance Physical Therapy have treatment options that will help speed your recovery, so that you can more quickly return to your active lifestyle. Our Treatment What can be done for the condition?
The MCP joint needs to be stable for the thumb to livament strong enough to grasp objects. The goal of our treatment is to help the ligaments Tbumb so that the thumb can be restored to full function. Non-surgical Rehabilitation If the thumb ligaments are only partially torn, they usually heal without surgery. Your thumb will be immobilized for four to six weeks in a special cast, called a thumb spica cast. Although there is concern regarding stress testing in the presence of a nondisplaced fracture, it is relatively safe to assume that, if the initial force of the injury did not displace the fracture, additional stress testing is not thought to be sufficient to displace the fracture .
If the MCP joint is unstable repaif stress or the avulsed fragment is displaced or malrotated repwir the proximal phalanx is subluxed, it has been shown that operative treatment is necessary . A standard lazy S-shaped incision over the dorsoulnar aspect of the thumb is used. The adductor aponeurosis is identified and separated from the joint capsule. For more common distal avulsions, proximally based flap containing UCL is raised and distally based flap containing UCL remnants, capsule, and soft tissue is raised off the ulnar edge of the proximal phalanx.
A temporary transosseous k-wire is used to hold the MCP joint in a reduced position while the ligament is repaired and tensioned, then removed at the end of the procedure. One or two 1. The distal flap is now secured on top of the repair using the same sutures from the anchor. In patients with avulsion fractures, small fragments are typically excised and the ligament is repaired back down to the bone with the same technique, whereas larger fragments are sometimes retained and incorporated into the repair [Figure 3] .