Gamekeeper Thumb Medication

  • Author: Michael A Secko IV, MD; Chief Editor: Rick Kulkarni, MD   more...
 
Updated: Feb 2, 2011
 

Medication Summary

Nonsteroidal anti-inflammatory (NSAIDs) that reduce pain and swelling are the treatment of choice.

A brief course of narcotics may be warranted to alleviate the acute phase of pain and swelling.

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Analgesics

Class Summary

Pain control is essential to quality patient care. Analgesics ensure patient comfort, promote pulmonary toilet, and have sedating properties, which are beneficial for patients who have sustained trauma or injuries.

Ibuprofen (Ibuprin, Advil, Motrin)

 

Usually DOC for treatment of mild to moderate pain, if no contraindications exist. Inhibits inflammatory reactions and pain probably by decreasing the activity of the enzyme cyclooxygenase, which results in prostaglandin synthesis.

Acetaminophen (Tylenol, Panadol, Aspirin-free Anacin)

 

DOC for treating mild pain in patients with documented hypersensitivity to aspirin or NSAIDs, those with upper GI disease, or who take oral anticoagulants.

Naproxen (Anaprox, Naprelan, Naprosyn)

 

Used for relief of mild to moderate pain. Inhibits inflammatory reactions and pain by decreasing activity of the enzyme cyclooxygenase, which results in prostaglandin synthesis.

Ketoprofen (Oruvail, Orudis, Actron)

 

Used to relieve mild to moderate pain and inflammation. Initially administer small dosages to patients with a small body size, elderly patients, and those with renal or liver disease. Doses higher than 75 mg do not increase therapeutic effects. Administer high doses with caution, and closely observe patients for response.

Acetaminophen and codeine (Tylenol #3)

 

Drug combination indicated for treatment of mild to moderate pain.

Oxycodone and acetaminophen (Percocet, Roxicet, Tylox)

 

Drug combination indicated to relieve moderate to severe pain; DOC for aspirin-hypersensitive patients.

Hydrocodone bitartrate and acetaminophen (Vicodin)

 

Drug combination indicated to relieve moderate to severe pain.

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Contributor Information and Disclosures
Author

Michael A Secko IV, MD  Clinical Assistant Instructor, Staff Physician, Clinical Assistant Instructor, Department of Emergency Medicine, Kings County Hospital, State University of New York Downstate Medical Center

Disclosure: Nothing to disclose.

Coauthor(s)

Mark A Silverberg, MD, FACEP, MMB  Assistant Professor, Assistant Residency Director, Department of Emergency Medicine, State University of New York Downstate College of Medicine; Consulting Staff, Department of Emergency Medicine, Staten Island University Hospital, Kings County Hospital, University Hospital, State University of New York Downstate at Brooklyn

Mark A Silverberg, MD, FACEP, MMB is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, Council of Emergency Medicine Residency Directors, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Joseph Kim, MD  Chairman, Department of Emergency Medicine, Western Medical Center; Clinical Instructor, University of California at Irvine

Disclosure: Nothing to disclose.

Specialty Editor Board

Robert M McNamara, MD, FAAEM  Chair and Professor, Department of Emergency Medicine, Temple University School of Medicine

Robert M McNamara, MD, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American Medical Association, Pennsylvania Medical Society, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Eric L Legome, MD  Chief, Department of Emergency Medicine, Kings County Hospital Center; Associate Professor, Department of Emergency Medicine, New York Medical College

Eric L Legome, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, Council of Emergency Medicine Residency Directors, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Rick Kulkarni, MD 

Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: WebMD Salary Employment

References
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  2. Hintermann B, Holzach PJ, Schütz M, Matter P. Skier's thumb--the significance of bony injuries. Am J Sports Med. Nov-Dec 1993;21(6):800-4. [Medline].

  3. Abrahamsson SO, Sollerman C, Lundborg G, et al. Diagnosis of displaced ulnar collateral ligament of the metacarpophalangeal joint of the thumb. J Hand Surg [Am]. May 1990;15(3):457-60. [Medline].

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  9. Jones MH, England SJ, Muwanga CL, Hildreth T. The use of ultrasound in the diagnosis of injuries of the ulnar collateral ligament of the thumb. J Hand Surg [Br]. Feb 2000;25(1):29-32. [Medline].

  10. Musharafieh RS, Bassim YR, Atiyeh BS. Ulnar collateral ligament rupture of the first metacarpophalangeal joint: a frequently missed injury in the emergency department. J Emerg Med. Mar-Apr 1997;15(2):193-6. [Medline].

  11. Newland CC. Gamekeeper's thumb. Orthop Clin North Am. Jan 1992;23(1):41-8. [Medline].

  12. Peterson JJ, Bancroft LW. Injuries of the fingers and thumb in the athlete. Clin Sports Med. Jul 2006;25(3):527-42, vii-viii. [Medline].

  13. Pichora DR, McMurtry RY, Bell MJ. Gamekeepers thumb: a prospective study of functional bracing. J Hand Surg [Am]. May 1989;14(3):567-73. [Medline].

  14. Richard JR. Gamekeeper's thumb: ulnar collateral ligament injury. Am Fam Physician. Apr 1996;53(5):1775-81. [Medline].

  15. Stener B. Displacement of the ruptured ulnar collateral ligament of the metacarpophalangeal joint of the thumb: clinical and anatomic study. J Bone Joint Surg [Br]. 1962;44:869-79.

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