Hand Case 10 History/Physical Exam

UCL Thumb Injury

Forced MCP abduction and hyperextension is a common mechanism, such as from a fall while skiing with a pole in one's hand or from one's thumb being hyperextended and abducted by the steering wheel in an MVC.

There is typically swelling and significant tenderness over ulnar aspect of the base of the thumb. A stress test of the UCL confirms the diagnosis. This is often a painful injury and painful maneuver, so the exam in the patient who has just been injured can be limited by pain.