Surgical management of chronic ulnar collateral ligament insufficiency of the thumb metacarpophalangeal joint.

We studied 33 patients with "gamekeeper's thumb" who underwent surgical treatment comprising ulnar collateral ligament (UCL) advancement in 14, arthrodesis in 11, reconstruction in 6, and primary repair in 2. Results were satisfactory in 76% of the cases and unsatisfactory in 24%. From our study and review of the literature, we concluded that the best results are obtained after surgical treatment in the acute stage, because results are inconsistent and poorer after treatment of chronic lesions; reconstructive procedures based on the surgical pathology are recommended over UCL advancement and late primary repairs; and arthrodesis is a reliable salvage procedure.