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Skier's Thumb

Surgery

If you elect to have surgery, then operative exploration and ligament repair using something called a "suture anchor" will most likely be performed. After the operation, your hand may be placed in a lightweight cast to hold your thumb still while your ligament heals. You will have to remain in this cast for some time based on your orthopedic surgeon's preferences, although some surgeons now advocate early gentle motion.

If you have an associated fracture with your skier's thumb, then it may be treated with a modified cast. Surgical stabilization of the fracture might be needed if a piece of bone has broken off.

Next Steps Follow-up

Your orthopedic surgeon will see you after surgical repair or after a period of immobilization in a cast. Your thumb will be reexamined. The doctor will decide if you need to continue to immobilize your thumb or if you need physical therapy to regain movement in it. The remainder of your rehabilitation and the management of any chronic problems that may arise from your injury will be addressed by your orthopedic or hand surgeon.

Prevention

 Skiers should be taught to consciously discard the ski pole during all falls. Falling onto an outstretched hand while skiing without the ski pole in hand should minimize the chance of injury. Skiers should also be encouraged to use poles with finger-groove grips without any restraining devices such as a wrist strap or closed grip.

You can prevent skier's thumb during a car accident by keeping your thumbs on the outside of the steering wheel along with your fingers. This new routine will require a conscious effort because most drivers are taught to grip the steering wheel in a fashion similar to a ski pole.

Outlook

  •  Acute partial rupture of the ulnar collateral ligament can be treated effectively with 4 weeks of immobilization in a special cast. Healing with full recovery is the rule with partial ruptures.
  • With a total rupture, either immobilization or surgical repair can result in partial or full recovery with the potential for long-term complications, including chronic pain and instability of the joint.

 

Multimedia

Media file 1: Skier's thumb. Fall on outstretched hand after discarding ski pole. Skier's thumb is unlikely with this mechanism of injury.

Media file 2: Skier's thumb. Fall on outstretched hand with ski pole in palm of hand. Skier's thumb is possible with this mechanism of injury.

Synonyms and Keywords

gamekeeper's thumb, gamekeeper thumb, skier's thumb, skier thumb, thumb sprain, sprained thumb, thumb pain, hand injury

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WebMD Medical Reference from eMedicineHealth

Reviewed by Varnada Karriem-Norwood, MD on May 05, 2014

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