There are two patients in your clinic with painful thumbs. One is a 60 year old male with a history of multiple falls to his out-stretched hand and thumb over his lifetime (skiing), who complains of difficulty gripping objects with his hands that has slowly worsened over the years. The other patient is a charming young lady who was cross-country skiing last weekend and fell on her hand, injuring her right thumb in the process.
Here is the video of their exams (about 3 MB file, so may take time to download):
You decide to X-ray their hands and here is what you find on a stressed view of the MCP joint:
You do some measurements:
Ulnar collateral ligament of the thumb
UCL tear (Complete)
Yes, referral to a hand surgeon for repair of the UCL.
Permanent loss of grip strength, DJD of MCP joint.
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