32-year old experiences deforming blow to left thumb

Diagnosis: This is a dislocation at the metacarpal-phalangeal joint, also known as “gamekeeper’s thumb.” This reduction needs to be done under proper sedation and muscle relaxation in order to minimally strain the supporting structures of the thumb. Inability to reduce this dislocation would require referral for orthopedic management. Complete tears of the UCL should be considered for surgical management. Partial tears of the UCL can usually be managed equally well with immobilization for 4 weeks.

Case presented by Nahum Kovalski, BSc, MDCM, Term Emergency Medical Centers, Jerusalem, Israel.
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Nahum Kovalski, BSc, MDCM

Clinical Researcher at TEREM Emergency Services