SKIERS (GAMEKEEPERS) THUMB

Skier’s thumb occurs when the ulnar collateral ligament at the base of your thumb gets stretched or torn. This ligament keeps your thumb stable when you pinch or grasp objects. Your range of motion may be limited.

If you have overstretched or injured your thumb you may be experiencing these symptoms:

• Pain and/or inflammation at the joint or base of your thumb
• Bruising 
• Pain or weakness when pinching an object between your thumb and forefinger
• Tenderness with or without movement

If the ligament in your thumb is partially torn, a splint or cast is usually worn for six weeks. After the splint or cast is removed, exercise therapy can help get your thumb to correctly move again. It will take several weeks for movement and strength in your thumb to return.

Depending on the severity of your injury, recommended treatments are:

• Rest, ice, compression, and elevation (RICE).  Resting your thumb by trying not to use it. Apply ice for 20 minutes every hour  Wrap your thumb in special tape or bandages. Elevate your hand above your heart.
• Non-steroidal anti-inflammatory drugs (NSAIDs). Over-the-counter drugs such as ibuprofen or naproxen can help reduce swelling and help with the pain.
• Prescription painkillers. If your pain is severe, Dr. Pournaras may prescribe pill medication, patch, cream, or gel.
• Splint, cast, or brace. Your thumb will need to rest. A splint, cast, or brace can help immobilize your thumb as it heals. .
• Physical therapy. Prescribed exercises are very helpful with increasing your range of movement and strengthening your thumb, hand, and wrist.

Your thumb will be swollen, bruised and very painful after this injury.

Treating this can will involve of a few weeks of having a splint on your thumb or in some cases, repair of the ligament with an surgery.

The most important part of deciding which treatment method will be used is to identify whether the ligament in your thumb is partly or completely torn. If it is torn, whether the ligament has been put into a position where healing may not be possible. (Sometimes called a Stener Lesion).

Dr. Pournaras will make this decision after a gentle examination to assess the degree of your  injury. Sometimes he will inject a local anesthetic around your thumb and examine the joint. An x-ray will help to determine if there is a fracture of the bone which the ligament is attached to.This may indicate a complete tear. An ultrasound can also help with this determination of surgery.

QUICK ANSWER: Surgical repair of your thumb is an outpatient procedure. The ligament is anchored back to the bone using pins or sutures. Your hand / thumb is then placed into a cast or splint to protect the surgical repair.

MORE DETAIL:
Surgery is usually performed as outpatient procedure under a block anesthesia. Meaning you will be awake, but your arm is temporarily numb to the point your will feel no pain before, during and after the operation and for several hours.

Dr. Pournaras will make an incision at the base of your thumb and reattach the ligament to the bone using stitches (sutures) and small anchors. He wil also repair to the tissue around it.

Many times this surgery requires, Dr. Pournaras to repair any bone fractures with wires or screws or pin the bone back into place. He will then place your thumb in a cast or splint to protect the repairs.

After surgery, your hand and forearm will be in a cast or splint for 6 to 8 weeks.