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REGIONAL ORTHOPAEDIC AND SPORTS MEDICINE CENTER

Game Keeper’s Thumb Common Ski Injury

December 21, 2017

 Ski season is upon us.  The fact that finding a place to ski in Texas is impossible does not mean the sport is unpopular with Texans.  On the contrary, skiing is an extremely popular sport among people in this area.  Orthopaedic and sports medicine clinics throughout North Texas are inundated with ski injuries of all sorts during the winter and spring months.

 

Snow skiing can be an extremely fun and exhilarating sport.  However, it is also one that is chock full of opportunities to injure the musculoskeletal system.  Broken bones, dislocated joints and sprained ligaments are just a few of the problems people return to Texas with.  There is one injury that is so common among snow skiers that it is actually called skier’s thumb.

 

Skier’s thumb was originally known as gamekeeper’s thumb, which was quite appropriate years ago.  Today, no one cam remember what a gamekeeper was, so the injury is now known as skier’s thumb or sometimes ski pole thumb.  Skier’s thumb is a sprain or tear of one of the ligaments of the thumb.  Specifically the ligament is called the ulnar collateral ligament (UCL).  The UCL becomes damaged when the thumb is forced away from the other fingers (abducted).  This typically occurs when the web of the thumb gets caught in the strap of the ski pole; it can also occur in other sports such as football or wrestling.

 

As with most things, a spectrum of damage is possible. For relatively minor sprains, several weeks of immobilization are usually sufficient to heal the injury.  A moderate amount of physical rehabilitation is usually required after the cast is removed.

 

For moderate sprains, a cast is usually placed on for a few weeks.  Then, the cast is removed and removable splint is fitted for a few more weeks while physically therapy is commenced.  At about three months, the injury if typically healed.

 

For complete tears of the ligament, surgery is indicated.  An orthopaedic surgeon makes a small incision over the ligament and reconstructs it.  The thumb is then casted for several weeks.  Subsequently, a moveable splint is put in place and physical therapy is begun.

 

It is extremely important to be evaluated by an orthopaedic surgeon if you injure your thumb skiing or otherwise.  The reasons in this case are numerous.  For younger athletes, the injury to the thumb may involve a fractured bone rather than the ligament.  It is very important to correctly diagnose a fractured bone in a child due to the possibility of a break through the growth plate.  For more mature athletes, an experienced examiner can often make the diagnosis of skier’s thumb without any special diagnostic tests.  Also, it is usually possible to assess the extent of damage form the physical examination.  This is important since surgery is necessary if there is a complete tear of the UCL.

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