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Download skier`s thumb/ ulnar collateral ligament sprain
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AMSSM SPORTS MEDICINE TOPICS SKIER’S THUMB/ ULNAR COLLATERAL LIGAMENT SPRAIN Patient Resource Courtesy of SportsMedToday.com. What is it? Sports Medicine Evaluation The ulnar collateral ligament is a strong band of tissue that resists separation of the thumb from the index finger. An ulnar collateral ligament sprain is a stretch or tearing of the ulnar collateral ligament. Acute sprains of the ulnar collateral ligament can occur when the thumb is pulled away from the index finger. This is a common injury in skiing, due to gripping the ski pole during a fall, so it may be referred to as “Skier’s Thumb”. It may also occur after falling on an outstretched thumb or hooking a thumb into a jersey or facemask. Work-up for a suspected ulnar collateral ligament injury begins with an examination of the injured wrist, hand, and thumb, as well as the uninjured wrist, hand, and thumb. This may include evaluation for tenderness over the inside of the thumb, usually near the base, as well as testing how loose the ligament is by bending the thumb away from the index finger. Imaging may be ordered to assist with diagnosis. X-rays should be performed, and an ultrasound or magnetic resonance imaging (MRI) may also be done. Symptoms Symptoms of an ulnar collateral ligament injury include pain over the inside of the thumb and pain with movement of the thumb. There may also be swelling. There can be decreased pinch strength, making holding objects between the thumb and index finger difficult. AMSSM SPORTS MEDICINE TOPICS SKIER’S THUMB/ ULNAR COLLATERAL LIGAMENT SPRAIN Treatment Treatment depends on severity of the injury. Sprains are graded as Grade I, II, or III. Grade I represents minimal stretching. Grade II represents more significant stretching or tearing. Grade III represents a complete tear. Grade I and II injuries can usually be treated by preventing thumb movement with a cast, taping, or splinting for up to 6 weeks. This may be accompanied with antiinflammatory medications, ice, and elevation. A Grade III injury may require surgical repair. Rehabilitation is commonly required as well. Injury Prevention Patient Resource Courtesy of SportsMedToday.com. AMSSM Member Authors: Mark Kasmer, MD, Matt Gammons, MD References Brukner P, Khan K. Brukner & Khan’s Clinical Sports Medicine. 4th Edition. Australia: McGraw-Hill Education; 2012. Eiff MP, Hatch R. Fracture Management for Primary Care. 3rd Edition. Philadelphia, PA: Elsevier Saunders; 2012. Ritting AW, Baldwin PC, Rodner CM. Ulnar collateral ligament injury of the thumb metacarpophalangeal joint. Clin J Sport Med. 2010 Mar;20(2):106-12. Rouzier P. The Sports Medicine Patient Advisor. 3rd Edition. Amherst, MA: Sportsmed Press; 2010. Most of these injuries occur as accidents that cannot be prevented. Ski poles that are strapless or have breakaway straps do not seem to decrease the risk of injury. Return To Play Return to play should be overseen by a sports medicine physician to ensure safe and timely return to sport. Most physicians will decide an athlete is ready to return to play once the thumb has full strength, pain-free full range of motion and ability the ability to protect the thumb during activity. This can take varying amounts of time, but on average about 6-8 weeks. AMSSM is a multi-disciplinary organization of sports medicine physicians dedicated to education, research, advocacy and the care of athletes of all ages. The majority of AMSSM members are primary care physicians with fellowship training and added qualification in sports medicine who then combine their practice of sports medicine with their primary specialty. AMSSM includes members who specialize solely in non-surgical sports medicine and serve as team physicians at the youth level, NCAA, NFL, MLB, NBA, WNBA, MLS and NHL, as well as with Olympic teams. By nature of their training and experience, sports medicine physicians are ideally suited to provide comprehensive medical care for athletes, sports teams or active individuals who are simply looking to maintain a healthy lifestyle. Find a sports medicine physician in your area at www.amssm.org.
