If the doctor determines that you have a skier's thumb, then referral to an orthopedic or hand surgeon will be the next step in your care. The orthopedic surgeon will determine when your thumb needs to be reexamined. At that time, your options for surgical versus nonsurgical therapy will be discussed.
Typically, partial injuries to the ulnar collateral ligament are immobilized for several weeks, while complete rupture of the ligament usually requires surgical repair.
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 in an unacceptable place.
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.
- 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 motor vehicle 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.
- 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.