An avulsion fracture at the ulnar base of the proximal phalanx of the thumb, due to force placed on the ulnar collateral ligament of the metacarpophalangeal joint.
Features Valgus instability
Management Place in a cast in adduction; if point instability is marked, open repair of ligament.
Note: The original gamekeeper’s thumb resulted from repetitive low-grade force, described in gamekeepers who used their thumbs to dislocate the necks of rabbits. Gamekeeper’s thumb now occurs more commonly in week-end warriors and ageing out-of-shape yahoos who play tackle football, in skiers who fall and get their hands caught in the strap of a ski pole, etc. The image is of George Barnes, head gamekeeper on the Dynevor estate, circa 1900.