Skier's Thumb Gamekeeper's Thumb

Skier's Thumb, also known as Gamekeeper's Thumb, occurs when the ulnar collateral ligament (UCL), which supports pinching and grasping activities, is torn or stretched. 

The UCL helps the hand to function properly, acting to keep the metacarpophalangeal (MCP) joint of the thumb stable.

Symptoms of Skier's Thumb:

  • Immediate pain
  • Bruising and Tenderness
  • Swelling and pain with pinching or grasping activities

Causes of Skier's Thumb:

Skier's thumb can occur when trying to break the force of a fall and the thumb is placed in a distorted position, such as that which may occur on the ski slopes with hands strapped to ski poles. This is why it is called Skier's Thumb. Gamekeeper's Thumb was coined earlier in Europe when this type of injury was frequently seen in Scottish gamekeepers, particularly rabbit keepers (related to the manner in which animals were killed).

Diagnosis and Treatment:

A physical examination will test the stability of the thumb joint. X-rays may be taken to ensure that a bone is not broken. A stress X-ray is a special type of X-ray that shows the joint while the ligament is subjected to stress. If the test causes pain, a shot of a local anesthetic may aide in making the diagnosis. An MRI may be necessary in developing a treatment plan. 

Treatment may include an ice pack to the injured site for two to three days following the fall. Immobilization with a splint or cast is indicated for partial tears, until healed (approximately six weeks). A complete UCL tear requires surgical repair. Following surgery, a brace is worn to protect the thumb ligament for six to eight weeks while the injury heals. Hand therapy may then follow.

 

© Copyright 2015 Dr. Allan Rosen MD