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Ulnar Collateral Ligament Injury (Skier’s Thumb)
If you attempt to stretch out your thumb until it can’t reach any further, then you are moving the ulnar collateral ligament. This band of tough, fibrous tissue, connects the bones at the base of the thumb. Athletes often hear the term “skier’s thumb” and “gamekeeper’s thumb.” Although they are similar conditions, they occur from different injuries.
In skiing accidents, when a skier falls while gripping the ski pole, the thumb can be jerked and pulled away from the hand. This places significant trauma and stress on the ulnar collateral ligament leading to an acute injury of the thumb. If the ulnar collateral ligament is pulled far enough, it will create a torn thumb ligament. This injury is also prevalent among baseball players who throw and catch at high speeds and can occur with a variety of other sporting activities where the hand is being used in a forceful manner.
Symptoms
Patients who sustain an acute tear of the ulnar collateral ligament may experience thumb pain, numbness, swelling and bruising at the base of the thumb. Grasping, throwing and holding objects firmly will be very hard if not impossible in some severe cases.
Treatment
Non-Surgical
Treatment depends on many factors associated with the ulnar collateral ligament injury. Dr. Millett will examine the injury and will consider how long ago it occurred, as well as the age and daily lifestyle of the patient. If the tear is partial and does not require surgery, Dr. Millett will most likely place the hand in a cast or wrist splint for about 6 weeks. Rest, anti-inflammatory medication and ice will help modify the pain and treat the injury.
Surgical
If severe instability in the thumb area exists, or if the tear is complete, then ulnar collateral ligament reconstruction surgery will be required. In injuries concerning the ulnar collateral ligament, the sooner the surgery can be performed, the better the healing process will be overall. Dr. Millett will use an arthroscopic approach to repair the torn ligament suturing the ends back together. If the ligament is torn from the bone itself, it will be sutured back to the bone. The older the thumb injury to the ulnar collateral ligament, the less likely this surgical procedure will be possible. In this case, a tendon transfer will be performed to compensate for the torn ligament.
Following surgery, patients are required to wear a cast for about 6 weeks after which moderate exercises and movements of the thumb can occur. Most patients are able to return to their sporting activities in roughly 3-4 months following surgery.
For more information on ulnar collateral ligament injury, or for additional resources on other elbow related injuries, please contact shoulder and elbow specialist Dr. Peter Millett in Vail, CO.
