SPLINT IMMOBILIZATION OF GAMEKEEPERS THUMB

Thirty-nine patients diagnosed with 40 acute complete ruptures of the ulnar collateral ligament of the thumb metacarpophalangeal joint were treated primarily with thumb spica splint immobilization. Duration of splinting ranged from 8 to 12 weeks. Thirty-four of these injuries (85 %) followed for 1 to 5 years (average 2.4 years) healed without signif icant instability, arthrosis, pain, or stiffness (range of motion with in 80% of the contralateral hand). Six ruptures (15%) demonstrated per sistent instability and pain at 12 weeks and were treated with surgica l reconstruction. Currently accepted guidelines for surgical intervent ion as primary treatment for ligamentous disruption at the thumb metac arpophalangeal joint may need revision. This study suggests that splin t immobilization is an effective primary treatment modality. The minor ity of patients who demonstrate persistent laxity can be successfully treated surgically with excellent results.