Thumb Sprain

Physical and occupational therapy can help restore movement to the thumb and allow you to resume normal activities as soon as possible.

A ligament is a tough band of tissue that connects bone to bone. The ulnar collateral ligament connects the base of your thumb to the middle bone of your thumb. When this ligament is sprained, the tissue has been overstretched and possibly torn. This injury is sometimes referred to as "skier's thumb," as it often occurs in skiing accidents.

Sprains are classified according to the extent of the injury:

• Mild (Grade I) sprains involve a tear of some of the fibers in the ligament. The thumb is still functional and healing is usually rapid.
• Moderate (Grade II) sprains occur when part of the ligament is torn from the bone. There is some loss of function and healing will likely last longer than with the mild sprain.
• Severe (Grade III) sprains result when the ligament is torn in two or the ligament separates from the bone. Thumb movement and stability are impaired and the ligament must usually be repaired surgically.

Causes
Accidents that force the thumb outward from the joint can lead to an ulnar collateral ligament sprain. Falling on an outstretched hand is a common cause of this kind of injury.

Symptoms
Symptoms include pain in the base of the thumb, especially when attempting to pinch or grasp objects. Movement of the thumb will be impaired and the joint may also swell and become discolored.

Diagnosis
Your doctor will ask you about the history of the injury and examine the joint. X-rays will be needed to rule out broken bones and, if necessary, an MRI (magnetic resonance imaging) study will be performed to gain a better view of the ligaments.

Treatment
Mild sprains usually heal well with conservative treatments such as:

• resting the area
• elevating the hand to promote fluid drainage
• using ice packs 3 to 4 times a day, 10 to 15 minutes at a time
• anti-inflammatory medications to decrease pain and swelling
• splinting or casting of the joint
• exercise to regain flexibility and strength
• physical and/or occupational therapy.

Moderate and severe sprains may require surgery to repair the ligament and restore stability to the joint. After surgery, you may need a splint on the thumb and wrist. Later, your doctor may also recommend that you wear a cast for about 6 weeks, depending on how you are healing.

Physical and occupational therapy can help restore thumb function and allow you to return to normal activities.

Outlook
As with all sprains, the key to a good recovery is early treatment. By following your doctor's instructions, the injury has the best chance to heal without complications. Your age, overall health, and the extent of your injury play a large role in your recovery.
Complications.

The most frequent complication in ulnar collateral ligament sprain is under-treatment resulting in chronic instability and pain at the base of the thumb. A non-treated injury may eventually result in the development of early osteoarthritis.