A skier's thumb is an injury caused by a rupture of a tendon in the area of the interphalangeal (distal) joint closest to the fingertip. If the injury is severe, the toe cannot be straightened and remains curved like a bird's claw.
The skier's thumbused to be called the forester's thumb. Thisthumb injurycan happen to anyone, but anyone who performs activities that require excessive stress on the thumb by pulling it away from the rest of the hand is particularly vulnerable to it. Like skiers, football goalkeepers and rugby players are at risk of injuries.
Skier's thumb: symptoms of injury
- pain on the elbow of the metacarpophalangeal joint of the thumb
- swelling and ecchymosis (in the first period)
- problem with holding large items in hand
- noticeable step (head of the metacarpal bone) with displacement of the detached ligament
- deflection of the thumb in full flexion (with large injuries)
Skier's thumb: diagnostics
First of all, an X-ray is performed to exclude a fracture. As visualization of the instability of the thumb in a radiographic examination would require its load, and consequently there was a risk of further ligament damage and displacement of the stumps, ultrasound and magnetic resonance imaging are usually used in later diagnostics.
Skier's thumb: conservative treatment
First aid is to put ice on your finger or put it under cold water to constrict small vessels and reduce internal bleeding and swelling. Over-the-counter pain relievers may be given to ease the pain. If the blow is very strong and the pain persists, contact your doctor. The sprain usually clears by itself in 4 to 6 weeks, but may be assisted by physical therapy, and sometimes the finger may need to be immobilized. However, if the ligaments are completely ruptured, surgical intervention may be necessary.
Skier's thumb: operation
Indications for surgery on the skier's thumb:
- displacement of the ligament stump (Stener damage)
- displacement of the bone fragment above 2 mm
- Instability exceeding 35 degrees (or 20 degrees from the pagehe althy)
- rotation of the bone fracture
- incompatibility of the articular surfaces found in the imaging examination
The procedure is performed under local anesthesia. The incision is made from the dorso-ulnar side. In the case of fresh injuries, the ligament is reattached at the detachment site (damage at distal attachment) or the stumps are sewn end-to-end (damage in the central part).
If 2-3 weeks have passed since the onset of the injury, the ligament has lost its ability to heal and a transplant is required for its reconstruction.