Abstract
Skier’s thumb is a partial or complete rupture of the ulnar collateral ligament of the metacarpophalangeal joint of the thumb. It is an often-encountered injury and can lead to chronic pain and instability when diagnosed incorrectly. Knowledge of the anatomy and accurate physical examination are essential in the evaluation of a patient with skier’s thumb. This article provides a review of the relevant anatomy, the correct method of physical examination and the options for additional imaging and treatment with attention to possible pitfalls.
Highlights
A partial or complete rupture of the ulnar collateral ligament of the metacarpophalangeal joint of the thumb, skier’s thumb, is an often-encountered problem
Some investigators have their reservations when testing the stability of the joint because they are worried about dislocating an avulsion fracture of the insertion of the Ulnar collateral ligament (UCL) onto the proximal phalanx
A study by Cooper et al [11] described how Oberst anesthesia increases the clinical accuracy from 28% to 98% after an average of one week after the initial trauma
Summary
A partial or complete rupture of the ulnar collateral ligament of the metacarpophalangeal joint of the thumb, skier’s thumb, is an often-encountered problem. Some investigators have their reservations when testing the stability of the joint because they are worried about dislocating an avulsion fracture of the insertion of the UCL onto the proximal phalanx. If there is an unstable joint for which no firm endpoint is found during testing, and/or there is a dislocated, malrotated bony fragment or one that is more than one third of the joint surface, surgery is considered the best treatment This applies to Stener lesions because the general idea is that the UCL cannot heal if it is not in contact with its insertion, even though no evidence can be found in the literature to support this notion. Not enough information is available on the chances for recurrence with this type of injury
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