When to Seek Medical Care continued...
If you determine that skier's thumb is possible, considering the way your accident happened, then you should be taken by car to a hospital's emergency department. There is no need to go by ambulance unless that is your only means of transportation or there is another more serious injury associated with the accident.
An alternative to the emergency department would be an office visit to an orthopedic surgeon (bone specialist) or hand surgeon's clinic. If an orthopedic surgeon is available to see you on the day of your injury, it is more efficient to go see the surgeon directly instead from the emergency department's referral.
Exams and Tests
The physician will first make sure you have no other limb-threatening injuries and then evaluate your thumb in more detail.
- The doctor will ask you how the injury happened. Be prepared to answer these questions:
- At what time did your injury take place?
- What was the exact positioning of your hand and thumb during the injury?
- How soon after the injury did the pain and swelling begin?
- Did it feel as if your thumb was stressed beyond its normal range of motion?
- The doctor will also ask about your past medical history. Be prepared to answer these questions:
- Have you ever suffered from a similar injury before?
- Have you ever had any type of surgery in your hand or wrist?
- Are you allergic to any pain medications?
- Have you ever fractured any bones in your wrist or hand?
- Are you right-handed or left-handed?
- What is your primary occupation?
- The doctor will then perform a physical examination.
- Testing the laxity (looseness) of the ulnar collateral ligament of your thumb: This test will be done by holding the base of your thumb in a fixed position, while applying a lateral (sideways) force on the tip of your thumb to see how many degrees it will move. This movement will be compared to the movement of your other, uninjured thumb. Pain may make this difficult to do immediately after the injury (in which case the injury may be treated and then reexamined in a few days).
- Assessing for normal functioning of the 3 major nerves in your hand
- Checking for point tenderness over certain bony spots of your hand that may indicate fracture
- X-ray of your hand to make sure no bones are broken
- Examining the rest of your arm for any associated injuries to your wrist, forearm, elbow, and shoulder
Skier's Thumb Treatment Self-Care at Home
If you suspect that you may have a skier's thumb, then home care should address the pain and swelling of your thumb. Take the following steps to minimize your pain and swelling.
- Apply ice to the thumb for 35 minutes at a time, up to 4 times per day. Do not apply ice directly to your skin. Continue to use ice until the pain stops. (You should see your doctor as soon as possible after the injury and then follow a doctor's directions for ice therapy at that point.)
- Avoid movement of the thumb as much as possible. The loose application of an ACE wrap or commercially available wrist brace in the neutral position will help immobilize the thumb. This will help lessen your pain.
- Take acetaminophen for pain relief or ibuprofen for anti-inflammatory action. Avoid both of these over-the-counter drugs if you have stomach problems and cannot tolerate them.
- The most important aspect of home care is to ensure that the injury is fully evaluated by an emergency doctor, orthopedic surgeon, or your primary care physician in the first few days.