Skier's Thumb: A Reason to Consider Snowboarding?

What is Skier's Thumb?

Skier's Thumb, also known as Gamekeeper's Thumb, refers to a tear of the ulnar collateral ligament (UCL) on the inside of the thumb. As the name suggests the injury is common in skiers. During a fall on the slopes the thumb can become jammed against the ski pole resulting in injury. A UCL tear can also occur through repetitive wear, but this is less common than traumatic causes. Symptoms can include pain, swelling, bruising and joint laxity.

How is Skier's Thumb Diagnosed?

A sports medicine physician will make the diagnosis based on your history of thumb injury along with correlating physical exam findings. A plain X-ray of the hand will be ordered and can help rule out an avulsion fracture (a fragment of bone separating from the main bone mass) that can also occur with trauma. Your physician may order a stress X-ray which can demonstrate the joint laxity indicative of ligament rupture. Additionally testing could include MRI or Ultrasound.

How is Skier's Thumb Treated?

If left untreated, a torn ulnar collateral ligament can lead to decreased pinch and grip strength. Treatment will depend on whether the tear is partial or complete. Partial tears can be treated conservatively with casting of the wrist for 4-6 weeks. Complete tears will typically require surgical repair by an orthopedist or hand surgeon. Following casting or surgery, rehabilitation can help improve strength and stability.

If you believe you may have Skier's Thumb, we recommend a consultation to discuss your diagnosis and treatment options with Dr. Carfagno.

 

Bryce Kirkman, MS-IV

David Carfagno, D.O., C.A.Q.S.M. 

 

References:

Graham, SM. Hand and Wrist Injuries in the Athlete. Warthog Sport Medicine Manual, 2000:471-520.

Hussain, WM. Athletic Hand and Wrist Injuries. Clevaland Clinic Sports Medicine Fellows Conference, 2011-2012.

Anderson D. Skier's thumb. Aust Fam Physician 2010; 39:575.

 

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