Thumb UCL Injury/Skier’s Thumb
“Skier’s Thumb” is a common injury, especially in active individuals. Skier’s thumb, also known as “gamekeeper’s thumb” involves an injury to the ligament on the inside of your thumb – the ulnar collateral ligament (UCL) of the thumb metacarpophalangeal joint. This injury can involve a sprain – in which case the ligament stretches or partially tears – or a complete tear leading to significant pain, weakness and instability of the thumb. The injury occurs most commonly from an acute traumatic event leading to hyperextension of the thumb.
Causes and risk factors
Trauma causing hyperextension of thumb
Commonly related to falls, especially while holding something in the hand such as a ski pole
Chronic instability may arise from repetitive injuries
Symptoms
Pain, swelling, bruising generally along the inside of the thumb
Weakness with pinching/gripping
Instability to the thumb
Diagnosis and treatment
In most cases, we will obtain radiographs to ensure there is no fracture to your thumb. Most of the time, the diagnosis can then be made clinically based on your exam and symptoms. Occasionally, advanced imaging such as an MRI will be obtained to evaluate the extent of the tear and help determine treatment options.
Treatment depends on the extent of injury to the ligament. In most cases, UCL injuries are treated non surgically with immobilization, often by casting initially and then transitioning to a removable brace. In general, it may take up to 3 - 6 months to fully recover and return to normal activity after a sprain/partial tear of the ulnar collateral ligament. Complete tears are treated surgically or non surgically depending on the pattern of tear and patient goals. Left untreated, complete tears can lead to chronic pain, weakness and instability of the thumb. Dr. Holt will be happy to evaluate you and discuss treatment options dependent on your specific injury and goals.
Thumb UCL Injury Surgical Information/Post Operative Instructions
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