Healing Thumb Issues Before they Become Chronic

Heading to the mountains each winter is a trip many people in South Louisiana look forward to each year. While it is a safe and exciting trip for most, unfortunately there are injuries that can occur on the slopes. One of which is called Skier’s Thumb. Skier’s Thumb is an injury to an important ligament, called the ulnar collateral ligament, that helps stabilize the inside of your thumb. It commonly occurs when skiers fall, and their pole gets caught in the snow while still gripping the pole tight. The pole can pull their thumb to the side with so much force that it can tear the ligament on the inside of your knuckle. Skiing is a common culprit, but the ligament can be injured in a wide range of patterns with the common theme of your thumb being forcefully pulled away from your hand. This can occur from any fall onto your hand and is often seen in athletes, especially soccer players.

The ligament can be partially torn or completely torn and can be associated with a small fracture of the bones of the thumb where the ligament is attached. People with this injury often complain of pain at the inside base of their thumb that is worse with grip and pinch. They may also complain of instability or painful catching of their thumb in pockets of their pants. These injuries should be evaluated by an orthopedic surgeon. X-rays and MRI are often necessary to evaluate the integrity of the ligament and stability of the joint. Treatment depends on the pattern and severity of injury. If the ligament is partially torn surgery is not necessary. Treatment would then consist of casting or splinting for four weeks. In more severe injuries, surgery is necessary for the ligament to heal properly and restore thumb stability. Surgery consists of anchoring the ligament back down to bone and is performed in an outpatient setting. If a fracture also occurs, screws or pins may be necessary. Full recovery is expected at roughly three months.

If this injury is ignored and the ligament doesn’t heal, a condition called Gamekeeper’s Thumb can develop. This is chronic injury of the ulnar collateral ligament that is named after Scottish hunters who would kill their game by grasping the head of the animal between their thumb and index finger to break its neck. The daily repetition would cause the ulnar collateral ligament to fail over time. This same outcome occurs if a Skier’s Thumb is not addressed in a timely manner. Once beyond the early period of the injury, the ligament becomes much more difficult to repair properly. Often, in chronic injuries, a new ligament needs to be made to stabilize the thumb. Therefore, it is very important to have suspected injuries evaluated as soon as possible. If you think you may have injured your thumb in this manner, call us at Louisiana Orthopaedic Specialists 337-235-8007 to request an appointment. We have fellowship-trained hand surgeons ready to help.
So, on your next ski trip, have fun but watch out for those ski poles.

-Dr Bryce Fugarino, MD.