gms | German Medical Science

Clinical issue/s: Most of the time, after ligament injuries, the recovery of hand function is easy with a self-mobilization education. But we have sometime patients with painful thumb and deficient function longtime after a sprain of the Ulnar Collateral Ligament (UCL)

Clinical reasoning: The understanding of the physiology of the metacarpo-phalangeal of the thumb and particularly the interlink between the ulnar ligament, the adductor pollicis aponeurosis and the extensor pollicis longus has permitted to improve the rehabilitation after UCL injury.

The adherence of the adductor aponeurosis blocks the gliding of the extensor pollicis longus tendon. The aim of the protocol of rehabilitation is to recreate the selective active motion of this tendon.

Innovative, analytical or new approach: The patient describes pains and inability to bend his thumb. In the case of the sprain of the UCL, a sample global approach of the motion of the thumb is inadequate for this particular trauma. The therapist have to do a precise testing of the extensor tendon gliding for diagnosing the blockage due to the fibrous healing of the UCL with the adductor aponeurosis.

Contribution to advancing HT practice: This protocol is simple to apply, it's enabling to recover the ability of the thumb after longtime of stiffness and chronic pain. the good results achieved on ten cases promote this rehabilitation protocol.