Skier's thumb

Overview

A fall on an outstretched hand can stress the thumb or tear the ligament at the inside base of the thumb. This causes immediate pain which worsens with movement, and can lead to instability in the thumb joint. Rapid cooling and elevation of the thumb can help to relieve the symptoms

Symptoms

Main symptoms

• Immediate pain, worsens with movement
• Difficulty grasping (weakness, loss of stability and sideways twisting is possible)
• Swelling and bluish bruise at the base of the thumb

Long-term complication

• Permanent instability (“unstable joint”) causes wear of the cartilage and leads to arthritis at the base of the thumb
  

Causes and treatment

Causes

• Reflexive opening of hand when falling
• Splaying of thumb upon landing causing it to bend away from the palm
• Stretching or tearing of the ligament on the inside base of the thumb
• A similar accident mechanism can be found in many situations: falling when skiing/riding a bicycle, household accidents, martial arts, gymnastics, etc.

Further treatment by your doctor / in hospital

Possible tests

• Careful examination of the thumb joint (incl. functional testing)
• X-ray to determine severity of injury

Possible therapies

• Hyperextension (sprain) and partial rupture (tearing of some fibres)
  • Immobilisation with a splint
  • Occupational therapy to rehabilitate the hand is beneficial
• Complete tearing of all structures (ligament tear) at the base of the thumb and breaking off of small pieces of bone
  • Surgery within the first ten days is recommended
    

What can I do myself?

• Apply the RICE guidelines:
  • Rest: immediately stop the sporting activity
    • Ice: cool the injury by applying ice, a cool pack (be careful not to apply directly to the skin) or moist compresses
  • Compression: using an elastic bandage
  • Elevate: keep the hand still, elevate when possible

When to see a doctor?

• No noticeable improvement in pain and swelling within three days or so
• Thumb weakness persists
  

Synonyms

skier's thumb, ulnar collateral ligament tear of the thumb, ulnar collateral ligament injury of the thumb