Gamekeeper's Thumb Test |
Other Names |
Thumb Ulnar
Collateral Ligament Laxity or Instability test |
Examination type |
Ligamentous
laxity, joint stability |
Patient & Body Segment Positioning |
Patient sits
with forearm in neutral and hand supported in a relaxed position
on the table surface. |
Examiner Position |
Sitting or
standing in front of the involved hand, the examiner stabilizes
the patients palm with one hand and just above the
metacarpophalangeal (MCP) joint of the thumb being tested with
the other hand. The thumb of the hand stabilizing the palm
should be placed on the lateral side of the patient’s MCP join
to act as a fulcrum during the test. |
Performing the Test |
The examiner
apples a valgus stress to the metacarpophalangeal (MCP) joint of
the thumb which stresses the ulnar collateral ligament. |
Tissues
Being Tested |
Ulnar
Collateral Ligament of thumb, volar plate, joint capsule |
Positive Test |
Pain and/or
excessive opening at the joint |
Interpretation |
If Valgus
stress is more than 35°, it indicates a tear of the ulnar
collateral and accessory collateral ligaments. Pain in the
region with no joint laxity indicates a sprain (10 or
20) of the ulnar collateral ligament. |
Common errors in
performing exam |
Applying
stress at the wrong joint; not allowing patient to relax |
Factors possibly
resulting in misinterpretation |
A
non-displaced avulsion fracture may also cause these signs and
symptoms. |
Related tests |
Compression
test to rule out fracture, ligamentous instability test for
fingers
|
References |
Magee, David
J. (2002). Orthopedic Physical Assessment. Philadelphia,
PA: Elsevier |
Links: |
http://www.emedicine.com/orthoped/topic112.htm |
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