What is Skier’s thumb?
This is the rupture of the ulnar collateral ligament of the thumb metacarpo-phalangeal joint, leading to thumb instability. It is usually caused by a fall whilst holding a ski-pole, or with an out-stretched thumb. This can be complicated by fractures and stenner lesions (where the ligament is abnormally located as a result of the accident).
What are the non-surgical and surgical options available?
With partial tears or non-displaced bony injuries, non-operative splints and protective rehabilitation will heal injuries successfully. With early complete ligament tears and ‘stenner’ lesions, surgical intervention under general anaesthetic to repair the torn structures is required. Occasionally an ultrasound scan is necessary to aid diagnosis in more complex cases.
How long do the results last for?
Once repaired and healed, the stability of the joint should last for life.
What are the risks?
The non-operative route can occasionally fail to heal the ligament sufficiently or leave a chronic ache in its place. Surgery leaves a scar on the hand, but these usually heal very well. Like with all surgery, bleeding is a theoretical risk. Tender scar tissue occasionally takes a few months to settle down with massage. Joint instability rarely recurs.
What are the success rates?
The success rates if treated quickly, after injury are good. The longer the injury is left and/or the more severe it is, the more challenging the solution(s).
How much does the surgery cost?
The indicative prices below include the surgical fee, any anaesthetic used and the associated fees from the consultant administering this, in addition to the hospital fee and all tests and follow up. An accurate breakdown and a detailed quote will be given following the initial consultation.
From £300 for a bespoke splint
From £3,500 for surgical repair/reconstruction under general anaesthetic
What general advice is there?
Following any surgery on the hand, swelling and discomfort is inevitable. Elevation of the affected arm and non-steroidal anti-inflammatory medication helps. Early immobilisation for 48 hours helps recovery but must be followed by appropriately gauged mobilisation. Simple pain relief (paracetamol and/or ibuprofen) taken one hour before hand therapy rehabilitation allows more exercises to be undertaken. Desensitisation with moisturiser and massage helps scars to soften and become less painful.
Facts for Skier’s thumb
- Surgery duration: 1.5 hours
- Type of anaesthesia: General anaesthetic
- Time in hospital: Day case
- Time off work: 1-6 week(s)
- Recovery time: 6 weeks
- First follow up appointment: 1 week
- Total number of follow up appointments: 3
- Pain management: Simple pain relief (paracetamol and/or ibuprofen)
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