Finger / Thumb Ligaments

The hand is extremely complex; as a result, there are a lot of ligaments in the hand, wrist and fingers. Ligaments attach a bone to a bone, usually across a joint. Ligament sprains or injuries occur in a number of ways but often through trauma, such as falling onto an outstretched hand.

Depending on the severity of a sprain/rupture, the damaged ligament may need to be immobilised in a custom-made splint. In a lot of cases, this is not required and Physio will help you regain your movement, function and strength in your hand and wrist.

  • Finger sprains

    The most commonly injured joint is the PIP joint (the joint in the middle of the finger) and the most commonly injured ligaments are the volar plates that run on the palm side of the joint. The volar plate normally prevents the finger from over-straightening but can be damaged when force is applied forcing the finger back. One of the common causes is a ball hitting the end of the finger forcing it into hyper-extension. When the ligament tears, in some cases it can pull off a small fragment of bone too (which we call an avulsion fracture). You may be required to have X-rays or scans to confirm the rupture and check if the joint is still in the correct alignment or for fractures.

    Usually, this is treated with splinting and rehabilitation/physiotherapy. Occasionally surgery may be required but this is not common.

  • Skier’s (or Gamekeeper’s) Thumb

    This is an issue to the ulna collateral ligament of the metacarpo-phalangeal joint. This is a strong ligament that supports the thumb in pinching and gripping tasks. If this is damaged it can cause long term thumb instability which can affect pain and function.

    It is most commonly injured when you fall onto an outstretched thumb and even more common if the thumb is also gripping something at the same time (commonly reported when skiers fall holding a pole, hence the name Skier’s thumb). You will usually find swelling and bruising at the thumb.

    The treatment for this is usually splinting (either custom-made in clinic or off-the-shelf) for a period of time, usually 6 weeks, followed by a rehabilitation programme to return normal strength and function back to the hand. Sometimes surgery may be required if the ligament has displaced to a position where it cannot heal, this is called a Stener lesion.

    In some rarer cases, there is no injury at all and it is a chronic stretching of the ligament that causes the injury- this is what is meant by Gamekeeper’s thumb. You will often find a loss of strength on pinching or gripping with the thumb