Thumb MCP Ligament Repair — Thumb MCP UCL/RCL Repair

University of Virginia Orthopaedic Surgery

Weight-Bearing

NWB surgical UE

Key Restrictions

No 2-point (tip) or 3-point (chuck/tripod) pinch strengthening until 8 weeks; no lifting/pushing/pulling; cast weeks 2-4, custom thumb spica weeks 4-8; residual MCP stiffness expected long-term

Timeline & Phases

Phase 1 (0-2 wks): thumb spica splint; Phase 2 (2-8 wks): cast wk 2-4 then custom hand-based thumb spica wk 4-8, thumb IP AROM, MCP flexion/extension with CMC joint blocking from wk 4-6, balanced pinch/grasp without resistance, gentle passive MCP flexion from wk 6; Phase 3 (8-12 wks): progressive grip/pinch strengthening, wean orthosis, prolonged low-load MCP flexion ROM

Notes

2-point and 3-point pinch strengthening contraindicated until 8 weeks; cast weeks 2-4 transitions to custom orthosis weeks 4-8; residual MCP stiffness expected long-term; may use neoprene thumb support after orthosis weaning; light sedentary ADLs allowed gradually after week 8

Published

09/2024