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THUMB

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CMC Arthritis

CMC Arthritis involves degeneration of the joint at the base of the thumb, affecting hand function and causing pain, especially during gripping or pinching. Early diagnosis and proper management help preserve mobility and reduce discomfort.

  • Definition: CMC arthritis involves breakdown of the cartilage of the the joint at the base of the thumb (where the first metacarpal articulates with the trapezium).

  • Causes: Aging, repetitive thumb use, joint instability, or past injury.

  • Types of Fractures:

           ~ Primary: Age-related cartilage wear

           ~ Secondary: Due to trauma or inflammatory arthritis

  • Symptoms: Pain at the thumb base, swelling, stiffness, decreased grip strength, difficulty with pinching or opening jars, and sometimes a visible bump at the base of the thumb.

  • Diagnosis Tools: Clinical exam (e.g., grind test) and X-rays for joint narrowing or deformity.

  • Risk Factors: Age (40+), female gender, repetitive hand activity, previous injuries, or joint laxity.

UCL Ligament Injury

UCL Ligament Injury involves damage to the ulnar collateral ligament of the thumb, which plays a key role in stabilizing the joint during gripping and pinching.

  • Definition: An injury to the Ulnar Collateral Ligament at the base of the thumb (MCP joint), often called “skier’s thumb” or “gamekeeper’s thumb.”

  • Causes: Sudden forceful thumb movement (e.g., during a fall), repetitive stress, or sports-related trauma.

  • Types:

           ~ Partial Tear: Ligament is stretched or mildly torn

           ~ Complete Tear: Ligament is fully torn, often requiring surgical repair

           ~ Stener Lesion: Torn ligament is displaced and cannot heal properly without surgery

  • Symptoms: Pain at the thumb base, swelling, bruising, weakness in grip or pinch, and instability of the thumb.

  • Diagnosis Tools: Physical exam (valgus stress test), X-ray (to rule out fracture), and MRI (to confirm ligament damage).

  • Risk Factors: Contact sports, skiing, falls, thumb hyperextension injuries.

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