Skier’s Thumb

Skier’s Thumb is an acute injury to the main ligament of the thumb called the ulnar collateral ligament (ligaments are soft tissue structures that connect two bones to make a stable joint). When you fall, it is natural to extend your arms to reduce the impact from hitting the ground. The way you land on your hand can stretch or tear the ulnar collateral ligament. The condition is called Skier’s Thumb because injury to this ligament is often seen among skiers who fall with the ski pole still in hand.

Tearing the ulnar collateral ligament will greatly weaken a person’s ability to pinch and grasp. Other symptoms include bruising, tenderness, and swelling. A doctor should be seen a soon as possible to ensure that the injury will not cause long-term weakness, pain, instability, and, ultimately, arthritis.

Dr. Pianka uses a special type of x-ray, called a stress x-ray, which shows the joint as he applies tension to the injured ligament. If the test causes pain, a shot of a local anesthetic may help.

Nonsurgical Treatment

If the ligament is only partially torn, Dr. Pianka may immobilize your thumb joint with a bandage, cast, or splint until it heals. To ease pain and swelling, you can place an ice pack on your thumb twice a day for a few days after the injury. For the first three weeks after your injury, the splint or cast should be worn at all times. After that, it can be taken off to do strengthening exercises for the thumb.

Surgical Treatment

If the ulnar collateral ligament of the thumb is completely torn, surgery to reconnect the ligament to the bone may be needed to regain normal movement and stability. In addition, when the ligament tears away from the bone, sometimes fragments of bone are pulled away with it. If this is the case, then the bone fragments may be removed or put back into the correct position and fixed with a pin or screw during surgery.

Another treatment option is a joint fusion procedure, which keeps the joint from moving. Done rarely, it may be called for when an injury is not treated for a long time and arthritis has developed.

After surgery, a short arm cast or a splint will be necessary for four weeks to protect the thumb ligament while it heals.