Gamekeeper's thumb: Early diagnosis and treatment

Injuries to the ulnar collateral ligament complex in the thumb are common and require prompt attention. Early diagnosis is essential and must differentiate a partial ligament sprain from a complete disruption. Accurate diagnosis requires a precise examination and roentgenographic evaluation. Provocative maneuvers and stress radiographs may be necessary to delineate the extent of injury. Partial injuries are treated effectively by thumb spica immobilization. Complete ruptures require operative intervention and anatomic repair. To optimize outcome, the operative procedure requires meticulous technique and should result in minimal morbidity. Late ulnar collateral ligament reconstruction is more complicated and inferior to early surgical repair.