Gamekeeper's, Skier's Thumb, Surgical Repair

You have injured some ligaments in your thumb. It may be difficult for you to hold things by pinching them between your thumb and finger. A complete tear of the ligament that stabilizes the thumb, if not repaired surgically, can lead to a loss of stability and function of the thumb. It got its name historically from when gamekeepers used to kill game (hunted or trapped) by pinning them down around the neck between their thumb and index finger. Your injury is a complete tear so it will require surgery for it to heal with the best results. The injury may take 6 to 8 weeks to heal depending on your health and rate of healing.

TREATMENT

Your injury requires an open reduction (open surgery) and repair of the injured ligaments.

LET YOUR CAREGIVER KNOW ABOUT:

  • Allergies.

  • Medications taken including herbs, eye drops, over the counter medications, and creams.

  • Use of steroids (by mouth or creams).

  • Previous problems with anesthetics or novocaine.

  • Possibility of pregnancy, if this applies.

  • History of blood clots (thrombophlebitis).

  • History of bleeding or blood problems.

  • Previous surgery.

  • Other health problems.

AFTER THE PROCEDURE

After surgery, you will be taken to the recovery area where a nurse will watch and check your progress. Once you are awake, stable, and taking fluids well, barring other problems you will be allowed to go home. Once home an ice pack applied to your operative site may help with discomfort and keep the swelling down.

HOME CARE INSTRUCTIONS

  • Follow your caregiver's instructions as to activities, exercises, physical therapy, and driving a car.

  • Daily exercise is helpful for maintaining range of motion (movement and mobility) and strength. Exercise as instructed.

  • To lessen swelling, keep the injured hand elevated above the level of your heart as much as possible.

  • Apply ice to the injury for 15 to 20 minutes each hour while awake for the first 2 days. Put the ice in a plastic bag and place a thin towel between the bag of ice and your cast.

  • Move the fingers of your casted hand several times a day.

  • If a plaster or fiberglass cast applied:

  • Do not try to scratch the skin under the cast using a sharp or pointed object.

  • Check the skin around the cast every day. You may put lotion on any red or sore areas.

  • Keep your cast dry. Your cast can be protected during bathing with a plastic bag. Do not put your cast into the water.

  • If your fiberglass cast gets a little wet, it can be gently dried using a hair dryer, taking care not to burn yourself.

  • If a plaster splint applied:

  • Wear the splint for as long as directed by your caregiver, or until you are seen for a follow-up examination.

  • Do not get your splint wet. Protect it during bathing with a plastic bag.

  • You may loosen the elastic bandage around the splint if your fingers start to get numb, tingle, get cold, or turn blue.

  • Do not put pressure on your cast or splint; this may cause it to break. Especially, do not lean them on hard surfaces for 24 hours after application.

  • Take medications as directed by your caregiver.

  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver.

  • IMPORTANT: follow up with your caregiver or keep or call for any appointments with specialists as directed. The failure to follow up could result in chronic pain and / or disability.

SEEK MEDICAL CARE IF:

  • Increased bleeding (more than a small spot) from beneath your cast or splint.

  • Redness, swelling, or increasing pain in the wound or from beneath your cast or splint.

  • Pus coming from wound or from beneath your cast or splint.

  • An unexplained oral temperature above 102° F (38.9° C) develops.

  • A foul smell coming from the wound or dressing or from beneath your cast or splint.

SEEK IMMEDIATE MEDICAL CARE IF:

You develop a rash, have difficulty breathing, or have any allergy problems.

If you do not have a window in your cast for observing the wound, a discharge or minor bleeding may show up as a stain on the outside of your cast. Report these findings to your caregiver.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.