Partial Ligament Tears in the Thumb: Treatment Options and Recovery

The thumb was accidentally bent backward, resulting in a partial ligament tear, and it has been nearly one year since the injury?

Hello, doctor.
My left thumb was bent backward during sports last November, causing significant pain and swelling.
I have been following up with orthopedic and rehabilitation specialists.
Recently, the MRI results showed that there is a partial tear in the tendons (or ligaments?) of my left thumb.
The orthopedic doctor mentioned that out of the six tendons, only two or three remain functional, and given the time that has passed, the chances of recovery are slim.
The rehabilitation efforts have not been very effective (the rehabilitation doctor recommended wax therapy and ultrasound).
The orthopedic doctor suggested surgery, which would involve cutting a segment of a tendon from the wrist for repair, explaining that there are three tendons in the wrist that serve the same function, so it would not affect daily activities, although it might impact strength.
Since I frequently play tennis, I am a bit concerned.
Upon consulting the doctor, I learned that I could also consider self-funded PRP (Platelet-Rich Plasma) therapy.
Currently, I feel a bit strange but not painful during regular activities, and I do not experience pain while playing tennis (when using a backhand).
However, if I overuse it (like writing too much as a left-handed person or playing for too long), I do feel pain, but it subsides after resting for a while.
The doctor mentioned that this is due to relying on the remaining tendons.
He also indicated that if I do not undergo surgery, there is a risk of increasing deformity, although I do not currently have any signs of this.
I would like to ask the doctor about the effectiveness of self-funded PRP therapy in stimulating tendon regrowth.
If I continue to leave this untreated, will there be any other long-term consequences?

Chen Dada, 20~29 year old female. Ask Date: 2018/10/06

Dr. Li Yongheng reply Orthopedics

Hello, your thumb has experienced a backward bend due to an accident, resulting in partial ligament rupture for nearly a year.
The effects of self-funded PRP therapy may not be very significant.
Therefore, it is recommended that you consult with another physician (a hand surgeon) to assess the necessity of surgery.
Wishing you a speedy recovery.

Reply Date: 2018/10/06

More Info

Understanding partial ligament tears in the thumb, particularly in the context of sports injuries, is crucial for determining the best treatment options and recovery strategies. From your description, it seems that you have sustained a significant injury to your left thumb, resulting in partial tearing of the ligaments or tendons. This type of injury can lead to pain, swelling, and functional limitations, especially in activities that require grip strength or fine motor skills, such as playing tennis.

Diagnosis and Initial Management
The initial assessment by orthopedic and rehabilitation specialists is essential. MRI findings indicating partial tears suggest that some of the ligament fibers are still intact, which is a positive sign for potential healing. However, the fact that you have been experiencing ongoing discomfort and functional limitations indicates that the injury may not be healing optimally. The recommendation for surgery to repair the torn ligaments is based on the understanding that surgical intervention can restore stability and function, especially if conservative treatments have not yielded satisfactory results.

Surgical Options
The proposed surgical option involves harvesting a tendon from the wrist area to repair the damaged ligaments in your thumb. This technique is often used when there is significant damage to the ligaments, and it can help restore function. While the surgery may affect strength, especially in the early stages of recovery, many patients find that they can regain a significant amount of function with proper rehabilitation. It is important to weigh the risks and benefits of surgery, especially considering your active lifestyle and involvement in sports like tennis.

Non-Surgical Options: PRP Therapy
Platelet-Rich Plasma (PRP) therapy is an emerging treatment option that utilizes components of your blood to promote healing in injured tissues. The idea behind PRP is that it contains growth factors that can stimulate the healing process in ligaments and tendons. While some studies suggest that PRP can be effective in treating tendon injuries, the results can be variable, and it may not be a guaranteed solution for everyone.

If you are considering PRP therapy, it is essential to discuss this with your orthopedic surgeon. They can provide insights into whether PRP is appropriate for your specific injury and how it may complement or serve as an alternative to surgical intervention.

Risks of Non-Treatment
If you choose to avoid surgery and continue with conservative management, there are potential risks to consider. Over time, the remaining intact ligaments may become overstressed, leading to further injury or degeneration. Additionally, if the thumb becomes increasingly unstable, it could lead to chronic pain, decreased function, and potentially the development of arthritis in the joint due to abnormal mechanics.

Conclusion
In summary, the decision regarding treatment for your partial ligament tear in the thumb should be made collaboratively with your healthcare providers, considering your lifestyle, the severity of the injury, and your personal preferences. Surgical repair may offer the best chance for a full recovery, especially given your active involvement in sports. However, if you are hesitant about surgery, exploring PRP therapy could be a viable option, although its effectiveness may vary. Ultimately, addressing the injury proactively will help prevent further complications and enhance your quality of life.

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