I fell on the slippery streets this winter. There’s a tear in the radial collateral ligament of my thumb. The doctor doesn’t think surgery is needed and put me in a cast. How is this decision made?

The radial collateral ligament in the thumb holds the base of the thumb and the wrist together. Deciding how to best treat an injury of this type has several steps. The doctor listens to the patient’s symptoms and looks for any signs of wrist, thumb, or hand deformity. A bump at the base of the thumb is a sign of a torn ligament.

Range of motion and strength are measured. Strength includes grip and pinch strength and along with your ability to use the thumb for daily activities. This is called functional strength.

An X-ray is also taken. The X-ray is often the final deciding factor. If there is a bone chip visible or the joint is wider than normal, surgery is needed.