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UCL Tear

What Is A UCL Tear​ Or Skier’s Thumb?

A UCL Tear (also known as Skier’s Thumb or Gamekeeper’s Thumb) is an injury to the ulnar collateral ligament, the soft tissue which joins the bones of the thumb. This ligament is important to the thumb’s grasping function, and a serious injury resulting in a complete tear of the ligament typically requires surgery to heal properly.

What Are The Causes Of Skier’s Thumb?

A UCL Tear can occur in any situation where the thumb is bent backward or sideways in an unnatural position with significant force. This injury is also known as Skier’s Thumb because a significant proportion of cases result from skiing accidents. This specific injury often happens when a skier falls on an outstretched hand while holding a ski pole. If a ball bends the thumb backwards this can also cause a tear of the ligament.

What Are The Signs And Symptoms Of Skier’s Thumb?

Symptoms of a UCL tear include pain in the webbing between thumb and index finger, bruise-like discoloration on the thumb’s skin, and swelling of the thumb that develops over the hours immediately following the injury. There is typically pain that worsens with any movement of the thumb, as well as tenderness along the inside of the thumb, closest to the index finger. Sudden inability to grasp between the thumb and index finger is also a possible indication of a UCL tear.

What Are The Risk Factors Of Skier’s Thumb?

UCL tears are most common in athletes who play contact sports such as football or basketball where the thumb can get jammed and forced into an unnatural position. Falls while holding an object in your hand can also cause skier’s thumb. In rare cases, UCL tears may occur from car accidents if a thumb is draped over the steering wheel.

How Is Skier’s Thumb Diagnosed?

If you’re struggling with thumb pain that may indicate Skier’s Thumb, Dr. Nance will begin by reviewing your medical history and getting basic details about how and when the injury occurred, the position of the hand and thumb, and when you began to notice bruising or swelling. She will then perform a physical examination to test the movement and stability of the injured thumb in comparison with the opposite, non-injured side. An examination of the rest of the hand, wrist, and arm will also be completed to rule out other connected injuries that may be the source of the pain. An X-ray will be taken to assess for any fractures or dislocations. Sometimes an MRI is necessary to diagnose the tear.

What Are The Possible Treatments For A UCL Tear?

If Dr. Nance determines that a patient has a UCL Tear, she will evaluate the seriousness of the injury before going forward with treatment. Whenever possible, Dr. Nance opts for treatment options that do not require surgery. In the case of a partial tear without instability, keeping the thumb immobilized with a special cast for roughly six weeks typically allows full healing. In the case of a full tear, Dr. Nance may have to perform surgery, followed by a period of immobilization to allow the injury to properly heal.

Are There Preventative Steps Or Measures To Avoid A UCL Tear?

Try not to land with your thumb in an outstretched position (easier said than done!). If you have thumb pain that persists for more than two days after a fall, seek medical attention from a hand surgeon.

What Are The Risks If Skier’s Thumb Is Left Untreated?

If the injury is not addressed within the acute period (roughly one month), direct repair of the ligament may not be possible. A larger surgical reconstruction with tendon graft may be required in these cases.

Are There Other Related Conditions To Skier’s Thumb?

Falling on an outstretched hand can also thumb fracture, thumb dislocation, or injuries to the radial collateral ligament (RCL), located in the elbow.

Key Takeaways About Skier’s Thumb

UCL Tears are caused by the thumb joint being bent or stretched backward or to the side, typically when sticking your hand out to catch yourself during a fall. If you are experiencing pain in the thumb joint for more than a couple days following this sort of injury, it’s important to seek specialized treatment as soon as possible. This injury can usually be diagnosed by a physical exam and X-ray, although your specialist may call for an MRI in some cases. While Skier’s Thumb often does not require surgery, failing to seek treatment early on can cause more complex intervention to be necessary later on.

Meet Dr. Erin Nance

Dr. Erin Nance specializes in orthopedic hand and upper extremity surgery, as well as traditional orthopedic services. Dr. Nance takes her time with every patient in her Midtown East, New York office, ensuring everyone gets the care and attention they deserve. Learn More »

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