What is skier's thumb?

Skier’s thumb is a common injury sustained when falling on an outstretched hand, causing the ligament on the inside of the thumb to become stretched or torn.

How does skier's thumb happen?

This classically happens when a skier plants their pole into snow and falls – landing with the pole still grasped in their hand causing the thumb to lever on the pole handle bending it sideways. The force may be great enough to sprain the ligament or cause a complete rupture. Any fall onto an outstretched arm resulting in forced abduction of the thumb, can injure the ulnar collateral ligament (UCL) so it is an injury not exclusive to skiers.

What are the symptoms of skier's thumb?

The thumb will be painful, swollen, bruised and weak. You will have difficulty in performing normally straightforward tasks such as a grip.

How is skier's thumb treated?

An early expert opinion from a hand surgeon is necessary. The clinical examination will include assessing the thumb for stability. This may involve numbing the thumb using local anaesthetic and gross instability can be diagnosed fairly easily as there will be no ‘end-point’ as the thumb ‘slides off’ radially on stressing.

If you have sprained your ulnar collateral ligament (UCL), then splintage and hand therapy may be all that is required.

If you have completely ruptured this ligament, then surgery is required. Surgery involves the reattachment of the ruptured UCL usually back onto its origin. This surgical procedure can be performed under regional anaesthesia (‘wide awake surgery’) or general anaesthetic dependent upon your preference.

If there is a delay in presentation or diagnosis, then the opportunity to perform a direct surgical repair is lost. This can lead to chronic instability, weakness and arthritis so a more complicated reconstructive procedure is required.

Recovery from skier's thumb

The repair is protected in a custom made thermoplastic splint for about 6 weeks. A hand therapist will supervise the splintage and rehabilitation in order to facilitate healing of the ligament and prevent stiffness.