Taken from www.bssh.ac.uk

Skier’s thumb (Gamekeeper’s thumb)

‘gamekeeper’s thumb’. Patients with this problem complain of a loss of strength when pinching or gripping with the thumb.

and after its removal a programme of exercises is used to get the thumb moving again. It can take several months for the movement and the strength to return.

What is it?

What are the symptoms?

If the ligament is completely torn then an operation to repair the ligament will be performed. This is followed by a similar period of splinting and subsequent exercise programme.

This is an injury to the ulnar collateral ligament of the metacarpo-phalangeal joint. This is a strong ligament that supports the thumb when pinching or gripping and if it is damaged may lead onto to a chronic instability of the thumb which causes problems with function.

The thumb will be swollen, bruised and painful. Treatment consists of either a period of splintage or a repair of the ligament with an operation.

The injury happens when you fall onto the outstretched thumb (see diagram)and is more likely if the thumb is gripping something at the same time. Falling when skiing while holding a ski pole is a common cause hence the name frequently given to this injury.

Making this decision may be possible with a gentle examination but it can be hard to decide as the thumb is sore and swollen. Other methods can be used to help with assessing the degree of injury. One maybe to inject some local anaesthetic around the thumb and to then examine the joint again. An x-ray may help if there is a fracture of a small fragment of bone which the ligament is attached to. Displacement of this fracture may indicate a complete tear. An ultrasound examination can help.

The outcome from this injury is generally for the ligament to heal and the thumb function to return to normal. Occasionally the ligament does not heal properly and the thumb becomes weaker and unstable. If this is a problem further surgery to reconstruct the ligament or fuse the joint can be done.