Skier's thumb injury – Whistler experience

Abstract

Thirty-eight per cent of skiing injuries seen at the Health Care Centre in Whistler, British Columbia are related to thumb injuries. A diagnosis of skier's thumb injury is made by clinical evaluation. The confirming diagnostic procedure is a positive stress test of the thumb, supported by supplementary investigations such as radiography, which may show an avulsion chip fracture with a localized area of tenderness. The treatment plan involves surgical exploration and ligament repair for total tear of the ulnar collateral ligament. Patients do extremely well with reconstruction and are able to return to skiing after six weeks, and to work between four to six weeks post surgery. Patients who refuse surgery do not do so well and have unstable painful thumbs with a weak pinch, and are likely to require future reconstructive surgery. Partial tears with a positive stress test have better results with surgical intervention and reconstruction of the ligament, rather than splinting alone. Finally, partial tears with a negative abduction stress test do well with splinting alone for six weeks.