Skip to main content
Log in

Skier’s Thumb

Treatment, Prevention and Recommendations

  • Injury Clinic
  • Published:
Sports Medicine Aims and scope Submit manuscript

Summary

Skier’s thumb is an injury to the ulnar collateral ligament (UCL) of the thumb metacarpophalangeal joint (MCPJ) which has a serious risk of disabling chronic instability if not treated adequately. The lesion most often occurs in skiers when the ski pole forces the thumb to deviate radially. Strapless poles do not decrease the incidence of skier’s thumb, but if skiers are trained to discard the pole during a fall the risk might be reduced. Clinical and anatomical findings and the understanding of the injury mechanism show that stability testing (performed with the joint in full flexion) and additional standard radiographs remain the keystones in decision making in all MCPJ sprains. Protective splinting is advocated in stable, undisplaced avulsion fractures and incomplete ligamentous lesions of the UCL. However, surgery should not be delayed where there are displaced bony avulsion fractures, and where a complete ligamentous rupture is suspected because of a more than 30° stressed radial deviation and more than 20° difference compared with the uninjured side. Controlled active range of motion exercises can usually be started 3 to 4 weeks after the injury or open surgical repair, respectively. Protective splinting is continued until the sixth week and unrestricted use allowed 12 weeks following injury.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Browne EZ, Dunn HK, Snyder CC. Ski pole injury. Plast Reconstr Surg 1976; 58: 19–23

    Article  Google Scholar 

  2. Mogan JV, Davis PH. Upper extremity injuries in skiing. Clin Sports Med 1982; 1: 295–308

    PubMed  CAS  Google Scholar 

  3. Lister G. The hand: diagnosis and indications. 3rd ed. Edinburgh: Churchill Livingstone, 1993

    Google Scholar 

  4. Stener B. Displacement of the ruptured ulnar collateral ligament of the metacarpo-phalangeal joint of the thumb: a clinical and anatomical study. J Bone Joint Surg Br 1962; 44: 869–79

    Google Scholar 

  5. Palmer AK, Louis DS. Assessing ulnar instability of the metacarpo/phalangeal joint of the thumb. J Hand Surg [Br] 1978; 3: 542–6

    CAS  Google Scholar 

  6. Gerber C, Senn E, Matter P. Skier’s thumb: surgical treatment of recent injuries to the ulnar collateral ligament of the thumb’s metacarpopha/langeal joint. Am J Sports Med 1981; 9: 171–7

    Article  PubMed  CAS  Google Scholar 

  7. Abrahamsson SO, Sollerman C, Lundborg G, et al. Diagnosis of displaced ulnar collateral ligament of the metacarpophalangeal joint of the thumb. J Hand Surg [Am] 1990; 15: 457–60

    Article  CAS  Google Scholar 

  8. Engkvist O, Balkfors B, Lindsjö U. Thumb injuries in downhill skiing. Int J Sports Med 1982; 3: 50–5

    Article  PubMed  CAS  Google Scholar 

  9. Hocker K, Pachuki A. Diagnostik und Behandlung der Bandverletzung am Daumengrundgelenk. Sportverletz Sportschaden 1992; 6: 165–9

    Article  PubMed  CAS  Google Scholar 

  10. Wilhelm K, Kreusser T, Euler E. Der Skidaumen. Orthopäde 1989; 18: 273–83

    PubMed  CAS  Google Scholar 

  11. Daly PJ, Sim FH, Simonet WT. Ice hockey injuries: a review. Sports Med 1990; 10: 122–31

    Article  PubMed  CAS  Google Scholar 

  12. Hintermann B, Holzach PJ, Schütz M, et al. Skier’s thumb — the significance of bony injuries. Am J Sports Med 1993; 21: 800–4

    Article  PubMed  CAS  Google Scholar 

  13. Massart P, Bèzes H. Severe metacarpophalangeal sprain of the thumb in ski accidents. Ann Chir Main 1984; 3: 101–12

    Article  PubMed  CAS  Google Scholar 

  14. Heyman P, Gelberman RH, Duncan K et al. Injuries of the ulnar collateral ligament of the thumb metacarpophalangeal joint. Clin Orthop 1993; 292: 165–71

    PubMed  Google Scholar 

  15. Späth HJ, Abrams RA, Bock GW et al. Gamekeeper thumb: differentiation of nondisplaced and displaced tears of the ulnar collateral ligament with MR imaging. Radiology 1993; 188: 553–6

    Google Scholar 

  16. Dray GJ, Eaton RG. Dislocations and ligament injuries in the digits. In: Green DP, editor. Operative hand surgery. 3rd ed. New York: Churchill Livingstone, 1993: 767–98

    Google Scholar 

  17. Louis DS, Huebner JJ, Hankin FM. Rupture and displacement of the ulnar collateral ligament of the metacarpophalangeal joint of the thumb: preoperative diagnosis. J Bone Joint Surg Am 1986; 68: 1320–6

    PubMed  CAS  Google Scholar 

  18. Feldmeier C. Verletzungen und Schäden an der Hand. München: W. Zuckschwerdt Verlag, 1988

    Google Scholar 

  19. Wadsworth LT. How to manage skier’s thumb. Physician and Sportsmedicine 1992; 20: 68–78

    Google Scholar 

  20. Sollerman C, Abrahamsson SO, Lundborg G, et al. Functional splinting versus plaster cast for ruptures of the ulnar collateral ligament of the thumb. Acta Orthop Scand 1991; 62: 524–6

    Article  PubMed  CAS  Google Scholar 

  21. Brown AF. Ulnar collateral ligament injury of the thumb. In: Clark GL, Shaw Wilgis EF, Aiello B, et al., editors. Hand rehabilitation: a practical guide. New York: Churchill Livingstone, 1993: 261–7

    Google Scholar 

  22. Helm RH. Hand function after injuries to the collateral ligaments of the metacarpophalangeal joint of the thumb. J Hand Surg [Br] 1987; 12: 252–5

    CAS  Google Scholar 

  23. Derkash RS, Matyas JR, Weaver JK et al. Acute surgical repair of the skier’s thumb. Clin Orthop 1987; 216: 29–33

    PubMed  Google Scholar 

  24. Rochat CH, Bachmann B, Heim U. Skier’s thumb [in French]. Schweiz Z Sportmed 1982; 30: 11–3

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fricker, R., Hintermann, B. Skier’s Thumb. Sports Med 19, 73–79 (1995). https://doi.org/10.2165/00007256-199519010-00006

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00007256-199519010-00006

Keywords

Navigation