Pathology
A skier’s thumb is an injury of the ulnar collateral ligament (UCL) of the metacarpophalangeal joint (MCP) of the thumb. This ligament provides stability to the thumb during gripping and pinching. The injury usually occurs due to a sudden sideways force on the thumb, for example after a fall while skiing with a ski pole in the hand. This may result in a sprain or a complete tear of the ligament. Typical symptoms include pain, swelling, and reduced grip strength.
Examination
The diagnosis is usually made based on clinical examination of the thumb. An X-ray is often performed to rule out an associated fracture. If necessary, an ultrasound or MRI can be used to better assess the severity of the ligament injury.
Treatment
Non-surgical
In cases of a partial tear, treatment usually consists of immobilization with a thumb splint or cast for a total of about 6 weeks, allowing the ligament to heal.
Surgical
In cases of a complete tear or clear joint instability, surgical repair of the ligament is often required. During the procedure, the ligament is sutured or reattached to the bone using a small anchor. After surgery, immobilization for about 6 weeks is also required.
Recovery
Regardless of the treatment, healing of the thumb may take a long time. Pain or sensitivity can sometimes persist for 6 months to 1 year after the injury. Gradual recovery of strength and mobility is therefore important.
