SKIER’S THUMB – QUESTION: A 26 year old female was skiing whilst on holiday and fell on her outstretched hand, resulting in her thumb hyperextending. It is now painful and swollen. Her thumb does not feel stable and she has difficulty turning keys, holding jars, and writing.
What is it?
Skier’s Thumb is where an injury occurs to Ulnar Collateral Ligament of the metacarpophalangeal joint of the thumb. The ligament can avulse a piece of bone off from it’s insertion or tear. It often occurs when someone falls on an outstretched hand and the thumb is hyperextended and abducted away from the palm. It can occur when someone falls over when skiing with the ski pole in their hand, hence the name Skier’s Thumb.
An X-Ray and Ultrasound can help to confirm diagnosis, and whether there is an avulsion fracture.
Most people with a Skier’s Thumb will be managed by their hand therapist. They require a custom made thermoplastic splint which supports the metacarpophalangeal joint of the thumb. The splint will leave the wrist, fingers and thumb interphalangeal joint free to move. You will also be provided with:
- Education about appropriate care of your swollen thumb
- Provision of a custom-made thermoplastic splint
- Exercises to non-involved joints
- Graded strengthening and range of motion exercises when appropriate, along with instruction in ongoing protection for sports and hobbies as required
Surgical review may be required if there is significant laxity of the thumb. Your therapist will be happy to discuss with you and your GP whether referral to a hand surgeon is appropriate.