thumb injuries jointsjoints metacarpophalangeal jointmetacarpophalangeal joint interphalangeal...
TRANSCRIPT
Thumb Injuries
• JointsJoints
• Metacarpophalangeal JointMetacarpophalangeal Joint
• Interphalangeal Joint Interphalangeal Joint
– Thumb (IP)Thumb (IP)
Flexion/Extension
Thenar Eminence
Abduction/Adduction
Opposition
Pinch
Thumb Ulnar Collateral Ligament SprainGamekeeper’sThumb
– EtiologyEtiology• Sprain of UCL Sprain of UCL • Forceful abductionForceful abduction• Occasionally combined w/ hyperextensionOccasionally combined w/ hyperextension
Normal abduction
Normal abduction with stress
Abnormal abduction with stress
– Signs and SymptomsSigns and Symptoms
• Pain over UCL Pain over UCL
• Instability with radial Instability with radial deviationdeviation
• Weak pinchWeak pinch
• Painful pinchPainful pinch
Gamekeeper’s Thumb– ManagementManagement
• Immediate follow-upImmediate follow-up
• If instability existsIf instability exists
– Referral to orthopedistReferral to orthopedist
– X-ray to rule out fractureX-ray to rule out fracture
• If stable splint If stable splint
– 3 weeks or until pain free 3 weeks or until pain free
– Extend from wrist to end of thumb Extend from wrist to end of thumb
– Neutral positionNeutral position
• Thumb spica after splintingThumb spica after splinting
Thumb DislocationBennett’s Fracture
•Structurally unstableStructurally unstable
•Should never be reduced without x-ray Should never be reduced without x-ray
•Must be referred to an orthopedic surgeonMust be referred to an orthopedic surgeon