Game Keeper Thumb. Case Study

It is an injury to the ligament of the thumb due to a fall with the load of the body transmitted to the thumb. Following a fall on the stretched-out thumb, the person gets swelling and pain on the inner aspect of the centre of the thumb. A special X-Ray called a stress view is obtained. To get a stress X-Ray view, the injured area is very gently deviated and stress to assess the extent of ligament injury. If the ligament is totally torn, the joint will open out abnormally and will be visible on the X-Ray. This shows abnormal opening on the medial (inner) side of the thumb. There may be a bony avulsion or purely ligament injury. In the normal thumb, the ligament is deep and muscle is superficial. In this condition, the injury causes the ligament to come to lie more superficial to the muscle. This reversal of the location of these structures is called as Stener lesion. This requires surgery to correct the Stener lesion. Special very tiny anchors may be required to fix the avulsion if bone is not of adequate size.

Case Study

Stress x ray shows abnormal opening on medial side of the thumb.

A tiny Anchor just before insertion.
After repair and insertion of anchor

It is an injury to the ligament of the thumb due to a fall with the load of the body transmitted to the thumb. Following a fall on the stretched-out thumb, the person gets swelling and pain on the inner aspect of the centre of the thumb. A special X-Ray called a stress view is obtained. To get a stress X-Ray view, the injured area is very gently deviated and stress to assess the extent of ligament injury. If the ligament is totally torn, the joint will open out abnormally and will be visible on the X-Ray. This shows abnormal opening on the medial (inner) side of the thumb. There may be a bony avulsion or purely ligament injury. In the normal thumb, the ligament is deep and muscle is superficial. In this condition, the injury causes the ligament to come to lie more superficial to the muscle. This reversal of the location of these structures is called as Stener lesion. This requires surgery to correct the Stener lesion. Special very tiny anchors may be required to fix the avulsion if bone is not of adequate size.

Case Study

Stress x ray shows abnormal opening on medial side of the thumb.

A tiny Anchor just before insertion.
After repair and insertion of anchor

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