Diagnosis Gamekeeper's Thumb
Diagnostic Process
If injury to the thumb occurs, one should seek an orthopedic specialist as soon as possible. Initially, an x-ray should be given to determine if there is a bone fracture. Determining if there is a fracture is critical as it will determine the type of treatment one should receive later (8). Additionally, even if there is no sign of fracture or ligament insufficiency seen in the x-ray, gamekeeper's thumb may still be present and further testing should take place.
After your orthopedic specialist has seen the x-ray images, he or she should perform two different stress tests, comparing the laxity (looseness of a ligament) of the injured thumb to the opposite healthy thumb. These tests will determine if the ulnar collateral ligament of the thumb has been compromised. One stress test should use the thumb in a slightly flexed position while the other uses the thumb in an extended position (2). Each test requires the orthopedic specialist to create radial deviation of the thumb in each position. If radial deviation of the thumb is greater than 20 degrees in the flexed position and 40 degrees in the extended position, gamekeeper's thumb should be assumed (10). Additionally, if radial deviation in either position is greater than 15 degrees than that of the opposite thumb, the injury can be assumed(2). More detailed information regarding diagnosis of gamekeeper's thumb can be found at:
Additionally, below is a video of the diagnostic procedure.
- http://www.wheelessonline.com/ortho/gamekeepers_thumb
- http://www.togct.com/downloads/bernstein/Gamekeepers-Thumb.pdf
Additionally, below is a video of the diagnostic procedure.