Treatment of Skier’s Thumbs:

1.    Splint – for 6 weeks . The commonest problem is failure to splint for long enough or failure to splint at all. The concern by many people is that the thumb will get stiff. This is not an issue in the thumb which behaves quite differently from the fingers.

2.    Cast- Most Ski injury patients are very active people who just want to get on with life. They have a tendency to do too much!!  In summary they need protection from themselves!! In view of this I treat many skiers thumb injuries in a cast so that they can’t take it off and forget to put it back on!!  This does not prevent them returning to skiing in the cast.

 
3.    Strapping – Particularly for Rugby players I suggest that after a Skier’s thumb that they strap their thumbs for the rest of their playing days. Ie the Thumb is never as strong as it used to be and is therefore potentially more prone to re-injury.

 
4.    Surgery
      a.    Direct ligament repair with or without an anchor
      b.    Excise fragment of bone & ligament repair

 

  

      c.    Internal fixation of fracture - If the fragment is large enough then it can be repaired with a screw. This gives the best longterm results because the original attachment of ligament to bone is preserved. 

   

      d.    Late reconstruction - Below a tendon graft is used to recreate the ulnar collateral ligament.

5.    Rehabilitation – See separate section.  The principles are to:

                          -allow the ligament to heal,

                          - then regain range of motion

                          - regain pinch strength and 

                          - to de-sensitise the scar if it is irritable.

6.    Prevention of Re-injury - See separate section