Hand injuries: gamekeeper thumb: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Hand injuries: gamekeeper thumb

Sample item

A skier falls with the thumb forced into abduction and is unable to pinch firmly. There is pain and laxity on radial stress of the thumb metacarpophalangeal joint. Which structure is torn?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Ulnar collateral ligament of the thumb MCP joint

Forced abduction of the thumb ruptures the ulnar collateral ligament at the metacarpophalangeal joint. This is skier's thumb when acute and gamekeeper's thumb when chronic. Loss of a stable pinch makes grip weak.

Option by option

  • A. Extensor pollicis longus tendon

    Extensor tendon rupture causes loss of thumb extension, not pinch laxity.

  • B. Radial collateral ligament of the thumb MCP joint

    The radial collateral ligament is injured by forced adduction, which is far less common.

  • C. Ulnar collateral ligament of the thumb MCP joint (correct)

    Correct. Radial stress laxity of the MCP joint indicates ulnar collateral ligament injury.

  • D. Volar plate of the interphalangeal joint

    Volar plate injury affects the interphalangeal joint, not MCP radial stress.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is C, Ulnar collateral ligament of the thumb MCP joint. Forced abduction of the thumb ruptures the ulnar collateral ligament at the metacarpophalangeal joint.

Why is "Extensor pollicis longus tendon" not the answer?

Extensor tendon rupture causes loss of thumb extension, not pinch laxity.

Why is "Radial collateral ligament of the thumb MCP joint" not the answer?

The radial collateral ligament is injured by forced adduction, which is far less common.

Why is "Volar plate of the interphalangeal joint" not the answer?

Volar plate injury affects the interphalangeal joint, not MCP radial stress.

What concept does this question test?

It tests Hand injuries: gamekeeper thumb in Orthopaedics. This is skier's thumb when acute and gamekeeper's thumb when chronic. Loss of a stable pinch makes grip weak.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hand injuries: gamekeeper thumb?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.