Skier’s Thumb, also known as a UCL tear, is a hand injury affecting the ligaments and bones in the thumb. Specifically, it is either a tear in the ulnar collateral ligament (UCL), or a bone fracture which forcibly separates the UCL from one of its connecting bones.

In the latter case, the injury has ripped a small portion of bone off where the ligament is connected, causing it to no longer be attached.

The UCL is one of the thumb ligaments that runs up the side of the thumb at its joints and provides some of the stability necessary in order to use it properly. The UCL connects the different bones of the thumb together to maintain its proper structure.

Skier’s Thumb injuries greatly compromise the sufferer’s ability to use their thumb properly. Besides the pain that the injury causes, the injury will inhibit tasks that require manual dexterity and fine motor skills.

Skier’s Thumb is usually more serious than a typical sprained thumb, and requires medical attention to treat properly.

Why Is It Called Skier’s Thumb?

Despite the name of the injury, Skier’s Thumb is not limited just to skiers. The condition is usually caused by a person falling on their outstretched hand. The sudden impact of the hand striking the ground or other surface causes the injury. As a result, a variety of different athletes, as well as ordinary people, can develop this injury.

There is, however, a reason for this injury’s particular name. While many other types of athletes can suffer from this, according to WebMD, up to 10% of skiing injuries are diagnosed as Skier’s Thumb.

It is especially easy for a skier to develop this injury because they are typically still holding a ski pole in the hand being used to block the fall. The mass of the ski poll pressed against the thumb as the hand strikes the ground provides the additional leverage to easily cause the injury.

Another variation of this injury is known as Gamekeeper’s Thumb, which is the result of constant stress to the UCL which causes it to weaken. It is a chronic condition caused by constant minor injuries to the ligament which results in long term damage. The name originates from the fact that gamekeepers would kill small game animals by using sudden pressure their thumb to break their necks.

How Skier’s Thumb Is Treated

The first step in treating Skier’s Thumb is a doctor’s examination. A doctor will be able to differentiate between ordinary thumb sprains and more serious injuries like this. An X-ray may be ordered to see how serious the injury is. Pain medications are typically prescribed. Doctors will typically give a referral to an orthopedic surgeon, especially in more serious cases.

A partial injury to the UCL will typically be treated by immobilizing the affected thumb for a few weeks. During this time, the ligament will likely be able to heal on its own.  Instead of a cast, patients usually wear splint for a designated period of time.  They may also be instructed to remove the splint periodically to perform simple thumb exercises to help preserve their thumb’s range of motion.

A full tear to the UCL or bone fracture separation detaching the UCL from one of its thumb bones will require surgery to repair. In the case of a fully torn UCL, a suture anchor will likely be used. Suture anchors forcibly affix ligaments and tendons to bone. From there, the tendon can heal naturally.

In the case of a fracture, surgery will likely still be necessary in order to affix the broken piece of bone to where it belongs. In both cases, it is typical for the hand to be placed in a cast for several weeks in order to prevent thumb movement. Wires may also be inserted into the thumb in order to maintain joint stability. During this time, the ligament will heal.

After several weeks in the cast, the orthopedic surgeon will determine whether the cast may be taken off or if it should remain for additional time.

Prognosis for Skier’s Thumb

In more serious cases, physical therapy may also be necessary in order to regain full function and range of motion in the thumb. Even with physical therapy, full function of the thumb may not be restored.

Strength training for the hand may also be implemented, especially in cases where the patient is an athlete.  Training is generally tailored to the needs and demands of the patient’s individual athletic activities.

Serious Skier’s Thumb injuries may also result in long term complications. For example, sufferers may develop chronic pain in their thumbs even after the injury has been healed. They may also have reduced joint stability as a result of their injury, which can pave the way for further thumb joint injuries in the future.

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