The Skier’s Thumb

The skier’s thumb is a common injury sustained when falling on an outstretched hand, resulting in a hyperabduction force to the thumb.


How does it 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 will you notice?

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

So you think you have skiers thumb, what should you do?

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.


What treatment options are there?

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 it’s origin. This surgical procedure can be performed under regional anaesthesia (‘wide awake surgery’) or general anaesthetic dependent upon your preference.


What next?

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.


What if I neglect my thumb injury?

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.


Skier’s thumb is a fairly common injury and best results are obtained when the injury is diagnosed and treated expertly. For a list of our hand surgeons click here, or call 0208 971 8026 for an appointment.


Date: 17/11/2016