Thumbs Up for Advanced Thumb Surgery
Thumb injuries are sometimes the result of a bad fall. More often, they are caused by a football, wrestling, or other athletic injury. Injuries at work also account for some thumb injuries.

When the radial collateral ligament (RCL) is torn, medical treatment is needed. This ligament goes between the radial bone of the forearm and the small bone at the base of the thumb (scaphoid). Without the RCL, pain and weakness occur. The patient typically has trouble grasping and lifting objects. Pinch strength is also affected.

Doctors don't have a "best" treatment for everyone with a torn RCL. Some use casting to hold the joint until healing takes place. Others suggest surgery to repair the tear. Treatment choices vary widely if the injury goes a long time without treatment.

One doctor did a study over a 20-year period of 45 patients with RCL injuries. The torn ligament and its covering were carefully pulled toward its normal attachment and held in place with sutures. A cast was put on the arm for six weeks.

The results of this study showed that repair of a torn radial collateral ligament may be all that's needed. Even late cases can be treated with this method. The author of this study concludes that using extra soft tissue to reinforce the site of injury isn't needed. A simpler repair gives long-term stability with relief of pain.
Michael P. Coyle, Jr, MD. Grade III Radial Collateral Ligament Injuries of the Thumb Metacarpophalangeal Joint: Treatment by Soft Tissue Advancement and Bony Reattachment. In The Journal of Hand Surgery. January 2003. Vol. 28A. No. 1. Pp. 14-20.