Skier’s Thumb: Skier’s thumb, also identified as Gamekeeper’s thumb, is an injury to the ulnar collateral ligament positioned in the metacarpophalangeal (MCP) joint where the thumb joins the hand. The ulnar collateral ligament (UCL) of the thumb is often injured as a result of forced abduction of the thumb, with or without extension.
The injury occurs when you fall onto the outstretched thumb and is more likely frequently happens during skiing accidents during which a person falls and doesn’t let go of the ski pole.
Skier’s/Gamekeeper’s Thumb Causes
Skiing accidents are the usual common causes of skier’s thumb. Fall on an outstretched hand with a ski pole in the palm of the hand creates to stress the thumb and stretch or tear the ligament. Another less probable cause of this injury is an automobile accident when the driver has the thumb alone wrapped around the steering wheel.
Symptoms of Skier’s/Gamekeeper’s Thumb
Patients with a Skier’s Thumb injury complain of pain, which is worsened by thumb extension or abduction, and swelling along the ulnar aspect of the thumb metacarpophalangeal joint. Symptoms of Skier’s/Gamekeeper’s thumb are –
- Swelling at base of the thumb
- Pain at the base of the thumb(Bruising )
- Difficulty grabbing objects
- Difficulty throwing objects
- Unstable thumb at its base
Grade of Skier’s/Gamekeeper’s Thumb
Thumb sprains can be mild to severe.
- Grade 1: Ligaments are stretched, but not split. This is a light injury. It can better with some lightning stretching.
- Grade 2: Ligaments are somewhat torn. This injury may necessitate using a splint or a cast for 5 to 6 weeks.
- Grade 3: Ligaments are totally torn. This is a severe impairment that may need surgery.
Skier’s/Gamekeeper’s Thumb Diagnosis
The physician will evaluate your thumb in more detail, and review symptoms and pain level. X-ray’s will determine if this represents strictly a ligament injury or if a piece of bone has pulled off with the ligament. MRI can be useful because it has the highest specificity and sensitivity.
Treatment of Skier’s/Gamekeeper’s Thumb
The ulnar collateral ligament is an important stabilizer of the thumb. Non-surgical Treatment Options for partial UCL tears-
- Ice to reduce swelling
- NSAID’S such as acetaminophen or ibuprofen to reduce pain
- Splint or cast
Typically, require immobilization with a brace or cast for four to six weeks. After the period of immobilization is over, the patient will perform exercises that help strengthen and stretch the joint in order to regain full function in your thumb. Gentle flexion and extension range of motion exercises can begin after about four weeks, with wear the splint between therapy sessions. After 8 weeks progressive strengthening exercises may begin. Gripping and pinching activities should not be started until 10-12 weeks, forceful gripping activities are typically not tolerated until about week 12.
If the ulnar collateral ligament is fully torn, surgery is usually expected, due to the unpredictable healing of complete tears.