Thumb MP Collateral Ligament Rupture

Rupture of the ulnar collateral ligament (gamekeeper's thumb; skier's thumb) occurs when the mechanism causes radial deviation (abduction) of the MP joint. The tear usually occurs at the insertion into the proximal phalanx. Often significant injury to the dorsal capsule and volar plate occurs. Stress testing of the ulnar collateral ligament is required and should be performed both in full extension and in 30° flexion. More than 40° of radial angulation indicates complete rupture and requires surgical consultation. Repair is best accomplished within 1 week. Radial collateral ligament rupture is not as common, and the mechanism is forced adduction.

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