What Is a UCL Thumb Lesion?

23 August 2017

The ulnar collateral ligament (UCL) of the thumb helps to stabilise the thumb and encourage efficient functioning. When trauma to the thumb occurs, such as a stener lesion, the UCL of the thumb can become ruptured, and will be unable to heal on its own.

Without the ability to correct itself, the UCL essentially becomes unable to function, and thus cannot provide stability or functioning of the thumb. In such a condition it will be essential to seek medical diagnosis and then treat the thumb and wrist to encourage proper healing. Read on to find out more about UCL lesions, how they can be caused, and what you can do to treat the condition should trauma occur. 

Where Is the UCL?

There are three types of ulnar collateral ligaments in the human body: those in the elbows, those in the wrists, and those in the thumb. The UCL in the thumb runs along the ulnar side of the metacarpophalangeal (MCP) thumb joint, a completely separate ligament to the UCL of the wrist joint which is paramount in stabilising the wrist and allowing it to function properly.

What Causes UCL Lesions?

UCL lesions are not a recently discovered condition: they are often described as a condition of gamekeeper's thumb, which extends as far back as the 1950s when Scottish gamekeepers would severely rupture their thumbs as a result of putting wounded rabbits to rest. As such, a UCL lesion is likely to occur following a traumatic injury to the thumb.

A stener lesion of the ulnar collateral ligament manifests as a result of the torn end of the UCL slipping, and causing the adductor pollicis muscle to fall between the UCL and the MCP joint. In short, the muscle between your index finger and thumb falls to the insertion site of the UCL, meaning the UCL cannot reconnect to sufficiently heal itself. In turn, this prevents the UCL from providing the thumb with the stabilisation and functionality it needs to operate on a daily basis.

Symptoms of a UCL Lesion

As a UCL lesion occurs as a result of a trauma, whether you're fallen onto your wrist or taken a knock to the hand, it is likely that you will be keeping a close eye on your thumb after the collision to monitor for any signs of underlying problems. As such, you will probably be aware of a problem with your thumb immediately after impact or injury.

As you may be unsure of what exactly the problem is with your thumb following injury, you may be able to identify the presence of a UCL lesion by the following:

  • Pain at the base of the thumb
  • Pinching becomes painful or even impossible
  • Loss of stability in the thumb

If any of these symptoms are present, an MRI or ultrasound may be required for proper diagnosis. Medical advice should always be sought if you are affected by the condition.

Treatments for UCL Lesions

Depending on the severity of the lesion, a different kind of treatment may be required over another. While your doctor will advise the best method of treatment for your individual condition, we've outlined the two most common approaches to treating a UCL lesion to help you better understand what options may be available to you.

Surgical Treatments

In most cases where a UCL lesion has occurred, surgery will be required. This is done to enable the ulnar collateral ligament to reconnect with its site of insertion, thus enabling self-healing within the hand. It may take a while during rehabilitation for full stability and functionality to be restored.

Using a Thumb Spica Splint

In milder UCL conditions, and for support with post-operative healing, a thumb spica splint can be worn. This will immobilise the thumb to prevent it from moving unaided or bending awkwardly, and in turn will protect it from further damage.

Wearing a thumb spica splint for less severe UCL lesions will prevent the affected ligament from becoming injured or worsening while it heals, and a splint can also encourage a quickened rate of healing following surgery to fix torn ligaments.

To view our full range of splints suitable for UCL lesions, follow the button below.


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