Skier’s Thumb

A thumb sprain is an injury of the main thumb ligament at the base of the thumb, the ulnar collateral ligament. Skier’s thumb is another term for a thumb sprain. Ligaments are the soft tissue components that hold two bones together to stabilize a joint. You weaken your pinching and grasping abilities if you tear the ulnar collateral ligament. Because of the popularity of recreational skiing in the United States, skier’s thumb is a common orthopedic injury. When the ulnar collateral ligament is completely torn, the injury must be surgically repaired.

What is the cause of skier’s thumb?

It is normal to extend your arms in front of you when you fall. People do this to reduce the impact from hitting the ground. With skiers and other who pitch forward, falling on the hand can stretch or tear the ulnar collateral ligament. Another cause of this injury is an automobile accident, with the driver’s thumb being impacted over the steering wheel. Basically skier’s thumb can result from any injury where the thumb is abnormally bent backward or to the side.

What are the symptoms of skier’s thumb?

The signs and symptoms of skier’s thumb can occur minutes to hours after the initial injury:

  • Swelling of the thumb
  • Pain at the base of the thumb and in the space between the thumb and index finger
  • Bruising of the skin over the thumb
  • Inability to grasp or weak grasp
  • Tenderness along the index finger side of the thumb
  • Thumb pain that is worse with movement
  • Pain in the wrist

How is skier’s thumb diagnosed?

To determine if you have a sprained thumb, I will examine your thumb in different positions to determine if your joint is stable. Also, diagnosis depends on your signs and symptoms as well as the history of your injury. I may perform X-rays to evaluate the joint with tension applied to the injured ligament. In addition, I check for normal functioning of the three major nerves of your hand.

What is the treatment for skier’s thumb?

Nonsurgical Treatment

Treatment depends on whether the ligament is stretched, partially torn, or completely torn. If only stretched or partially torn, I immobilize your thumb joint with a splint or bandage until it heals. For relief of pain and swelling, I recommend ice application 3 or 4 times each day. You will wear the splint or bandage for at least three weeks. After a specified amount of time, I encourage you to do strengthening exercises for your thumb. Physical therapy helps with this. This will continue for another 2 or 3 weeks. Most stretching and partial tearing injuries of this ligament heal after 4 to 6 weeks.

Surgical Treatment

When the ulnar collateral ligament is completely torn, surgery is often necessary. This procedure involves reconnecting the ligament to the bone to regain normal movement. With a skier’s thumb injury, the fragments of the bone may be pulled away with the torn ligament. These types of injuries require fixation with a pin or screw. After your surgical procedure, you will wear a short arm cast or splint for 6 to 8 weeks while the ligament heals.

What is my prognosis like with skier’s thumb?

The prognosis of this type of injury depends on the severity of the tear, how soon you get treatment, and your current bone and joint health. If a sprained thumb is treated promptly and properly, full normal function will be preserved and restored. If you delay treatment of skier’s thumb, however, chronic weakness, instability, and/or arthritis could develop. These late complications can be repaired with a joint fusion procedure or ligament rebuilding procedure.

Can I prevent skier’s thumb?

If you ski, you should discard the ski pole when you fall. Falling onto an outstretched hand without the pole will lessen your chance of a sprained thumb. Also, you should use a ski pole with finger-groove grips without restraining devices such as a closed grip or a wrist strap.

What should I do if I suspect I have skier’s thumb?

If you think you have sprained your thumb, I recommend you be evaluated as soon as possible in our office. While you are making your appointment, apply ice to the injury for around 30 minutes at a time. Avoid moving the thumb, and immobilize it with an ACE wrap. Take some ibuprofen for pain relief and anti-inflammation action.

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About Scott D. Ruhlman

Scott D. Ruhlman, MD Dr. Ruhlman offers the highest quality specialty care of hand, shoulder and elbow disorders. In addition to caring for such disorders in both the child and the adult, Dr. Ruhlman offer state-of-the-art fracture care, sports medicine and joint replacement surgery of both the upper and lower extremities.