Gamekeeper’s Thumb with Stener Lesion in a High School Football Player: A Case Study

Abstract

This disablement model case study outlines a unique thumb pathology of a high school football player in his non-dominant hand and will detail the benefits of quick referrals for patient with extreme laxity and swelling around the 1^st metacarpal. Initially, the patient presented with laxity of the 1^st metacarpophalangeal joint and swelling along the 1^st metacarpal. Radiographs showed floating bone fragments in the first metacarpophalangeal joint indicating Gamekeeper’s Thumb, an acute injury to the 1^st metacarpophalangeal ulnar collateral ligament, complicated by a Stener lesion, requiring surgical repair. The patient was scheduled for surgery in the following week and was casted for four weeks which posed many physical, occupational, and social problems. Many 1^st metacarpal injuries may present similarly making it important to be familiar with the structure and function of the 1^st metacarpal and metacarpophalangeal joint and concomitant injuries that may occur in the surrounding area. A Stener lesion is often missed due to the evaluator assuming that the injury is a basic 1^st metacarpophalangeal ulnar collateral ligament sprain.  The best way to rule in or out the involvement of a Stener lesion is by radiograph; therefore, it is in the best interest of the athlete to refer for a radiograph anytime a grade III ulnar collateral ligament sprain of the 1^st metacarpophalangeal joint is suspected. Furthermore, the main purpose of this paper is to detail the importance of a quick referral when there is little to no ability to use the thumb and the effects the lack of movement can have on a young student-athlete.