The human wrist joint is a complex arrangement of small bones and ligaments that form a mobile yet stable link from the powerful forearm to the hand. The normally functioning carpus can position the hand precisely relative to the forearm and provides remarkably stable transmission of forces. Motion and stability of the carpus provide the critical foundation for maximum hand function from precise fine motor control to power grip activities. When the normal mechanics of the wrist are disrupted, the instability of the carpal bones results in weakness, stiffness, chronic pain, and often arthritis if not treated appropriately. Although the early clinical and radiographic findings may be subtle, an understanding of wrist kinematics and instability patterns can facilitate early diagnosis and management. Unfortunately, selecting the optimal treatment remains a difficult judgment in most cases.
Synonyms and related keywords: carpal instability, wrist instability, shakes, dorsal intercalated-segment instability, DISI, a fall on an outstretched wrist, a fall on an outstretched hand, scapholunate interosseous ligament, SLIL, lunotriquetral interosseous ligament, LTIL, volar intercalated-segment instability, VISI, scaphoid shift test, Kleinman shear test, Reagan shuck test, pivot shift test, radiocarpal ligament, radioscaphocapitate ligament, RSC ligament, radioscapholunate ligament, RSL ligament, short radiolunate ligament, SRL ligament, long radiolunate ligament, LRL ligament, ulnolunate ligament, UL ligament, ulnotriquetrum ligament, UT ligament, scaphocapitate ligament, SC ligament, dorsal intercarpal ligament, DIC ligament, adaptive carpal instability, ulnar translocation, Blatt dorsal capsulodesis
Berdia & Shin 2005

Gamekeeper's thumb was originally described by Campbell in 1955 when he reported chronic laxity of the ulnar collateral ligament (UCL) of the thumb in 24 Scottish gamekeepers. The injury occurred as gamekeepers sacrificed wounded rabbits and other small game by breaking their necks between the ground and their thumbs and index fingers. Today, this injury is more a result of delayed treatment of an acute injury. The alternative term skier's thumb was popularized by Gerber et al and has become more synonymous with an acute injury. A significant proportion of these injuries are a result of fall or blows to the thumbs. One of the common mechanisms is a skier landing against the ski pole or ground while the thumb is abducted causing a valgus force on the thumb.
Synonyms and related keywords: skier thumb, injury to ulnar collateral ligament, UCL, hyperabduction of thumb, gamekeeper's thumb
Secko, Silverburg & Kim 2006

Campbell originally coined the term gamekeeper's thumb in 1955,1 because this condition was most commonly associated with Scottish gamekeepers, especially rabbit keepers, in whom the injury was work related. The injury occurred as the men sacrificed game such as rabbits; the animals' necks were broken between the ground and the gamekeeper's thumb and index fingers. As a result, a valgus force was placed onto the abducted metacarpophalangeal (MCP) joint, leading to an ulnar collateral ligament (UCL) injury and resulting in instability that was accompanied by pain and weakness of the pinch grasp. (See also the eMedicine article Gamekeeper Thumb.)
In the present day, this type of injury is typically more acute. The most common mechanism is a skier landing on the ground with his or her hand braced on a ski pole, causing a valgus force on the thumb. The term skier's thumb reflects the acute nature of the injury.
Synonyms and related keywords: metacarpal fracture and dislocation, metacarpophalangeal joint dislocation, MCP joint dislocation, phalangeal fracture, skier's thumb, instability of the thumb, Stener lesion, ulnar collateral ligament tear, UCL tear, proper collateral ligament tear, thumb injury, thumb pain, gamekeeper's fracture, thumb instability
Hannibal & Roger 2007

Phalangeal fractures are common injuries that may significantly affect hand function if not managed appropriately. Closed treatment has been the mainstay of treatment. Percutaneous pinning allowed the conversion of more unstable fracture patterns to stable configurations capable of tolerating early motion. More recently, minifragment screws and plates were developed to assist in the management of complex phalangeal fractures.
Synonyms and related keywords: phalangeal injuries, phalangeal fractures, phalangeal dislocation, proximal interphalangeal joint, PIPJ, finger injuries, finger fracture, broken finger, dislocated finger, jammed finger, finger dislocation, PIP joint, PIP, axial blow, crush injury, crushed finger
Divelbiss & Baratz 2008

Interphalangeal (IP) joint dislocations of the fingers and toes are common. Typically associated with forced hyperextension or hyperflexion of the digit, they require immediate reduction. The IP joint is a hinge joint that allows only flexion and extension and consists of several ligamentous complexes. The volar plate provides stability against hyperextension injury and dorsal dislocation of the phalanx. It often ruptures during a dorsal dislocation and may be associated with an avulsion fracture at the base of the phalanx. The strong collateral ligament complex resists hyperextension and lateral dislocation injury. The extensor hood complex stabilizes against hyperflexion injury and volar displacement of the phalanx.
Synonyms and related keywords: IP, finger, toe, proximal interphalangeal joint, PIP, distal interphalangeal joint, DIP, IP joint dislocations, interphalangeal joint dislocations, interphalangeal dislocations, toe dislocation, finger dislocation, dorsal PIP dislocation, volar IP dislocation, IP joint, PIP joint dislocations, DIP joint dislocations, thumb dislocation
Author: Grace M Young, MD 2008

Dislocation of a joint occurs when traumatic forces cause complete loss of continuity between the joint’s 2 articulating surfaces. Subluxation, on the other hand, occurs when the loss of continuity between the joints is only partial. A dislocation may or may not involve a fracture. Dislocations of the finger joints involve either the interphalangeal (IP) joint or the metacarpophalangeal (MCP) joint.
Synonyms and related keywords: finger dislocation, DIP, dislocation, distal interphalangeal joint, finger, interphalangeal joint, IP, phalanges, PIP, proximal interphalangeal joint, splint, subluxation, thumb, MCP, metacarpophalangeal, finger subluxation, thumb dislocation, thumb subluxation, thumb reduction, joint reduction, finger reduction, finger splint, thumb splint, volar splint, dorsal splint, digital nerve block
Polansky & Kwon 2007

Despite the inherent stability of the joints of the thumb, the vulnerable anatomic position of the first phalangis often subjects the joints to mechanical strain that leads to subluxation or dislocation of the metacarpophalangeal (MCP) and interphalangeal (IP) joints.
Despite the inherent stability of the joints of the thumb, the vulnerable anatomic position of the first phalangis often subjects the joints to mechanical strain that leads to subluxation or dislocation of the metacarpophalangeal (MCP) and interphalangeal (IP) joints.
Rodriguez & Davenport 2007

Sprains and dislocations of the metacarpophalangeal joint (MPJ) of the finger are relatively rare due to the protected position of this joint in the hand. Injuries to the MPJ of the thumb are more common, although these usually consist of collateral ligament injuries rather than dorsal or palmar dislocations.
Synonyms and related keywords: finger dislocation, finger sprain, thumb dislocation, thumb sprain, dislocated thumb, dislocated finger, sprained finger, sprained thumb, jammed finger, MCP sprain, MCP dislocation, MCP joint dislocation, MCP joint sprain, MPJ sprain, MPJ dislocation
Author: Matthew Gammons, MD 2005

Perilunate dislocations and perilunate fracture dislocations are the most devastating closed injuries of the wrist.1, 2, 3 They are often missed on initial evaluation, leading to devastating complications. These injuries occur as the final stage of a spectrum of injuries progressing around the wrist in a radial-to-ulnar direction. In the setting of a high-energy wrist injury, radiographs must be carefully scrutinized for the presence of the perilunate dislocation or one of its variants. Prompt open reduction with ligamentous repair or reconstruction is necessary to achieve favorable results. Posttraumatic arthrosis may result following these injuries irrespective of treatment, requiring a late salvage operation.
Synonyms and related keywords: perilunate dislocations, de Quervain fracture, de Quervain's fracture, retro-lunate dislocation, retrolunate dislocation, carpal instability complex, wrist injury, wrist pain, carpal instability dissociative, CID, dorsal intercalated segment instability, DISI, volar intercalated segment instability, VISI, carpal instability nondissociative, CIND
Author: Peter M Murray, MD, 2008

Injuries to the ulnar collateral ligament (UCL) of the thumb were first recognized as an occupational condition in European gamekeepers. By repetitively wringing the necks of game (eg, chickens) between their thumb and index finger, these workers produced a chronic stretching of the UCL that resulted in instability at the first metacarpophalangeal (MCP) joint. The condition became known as gamekeeper's thumb. Today, the injury is primarily caused by acute (rather than chronic and repetitive) damage to the UCL, most often due to a skiing accident; hence, the condition is now commonly referred to as skier's thumb.
Synonyms and related keywords: gamekeeper's thumb, break dancer's thumb, injury to the ulnar collateral ligament of the first metacarpophalangeal joint, UCL injury
Foye et al 2007

In his now classic 1962 article, Bertil Stener described a distinct, surgically correctable anatomic lesion that could account for the chronic instability found in the thumbs of some gamekeepers and skiers. CS Campbell first coined the term gamekeeper's thumb in 1955, when he described insufficiency in the ulnar collateral ligament (UCL) of the thumb metacarpophalangeal (MCP) joint in many Scottish gamekeepers.
Stener described a lesion produced by forced thumb abduction in which the distal attachment of the UCL was traumatically avulsed from the proximal phalanx of the thumb. The severed end would become caught under the adductor aponeurosis and therefore be unable to return to its anatomic position. Consequently, the severed ligament would fold on itself and thus be prevented from healing and restoring stability to the MCP joint
Synonyms and related keywords: gamekeeper's thumb, skier's thumb, insufficiency of the ulnar collateral ligament of the thumb metacarpophalangeal joint, UCL, MCP, thumb injury
Rectenwald & Walsh 2007