Suffering from ‘skier’s thumb’? How to repair ulnar collateral ligament injury

Suffering with ‘skier’s thumb’? How to repair ulnar collateral ligament injury
Published: May. 25, 2022 at 5:04 PM CDT|Updated: Jun. 15, 2022 at 4:11 PM CDT
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DAVENPORT, Iowa (KWQC) -A UCL injury is a tear or other damage to the soft tissue that connects the bones of the thumb and provides stability to the thumb joint. The condition is often referred to as skier’s thumb because it is a common injury in the sport.

Dr. Megan Crosmer, MD, Orthopaedic Specialists of Davenport, discusses treatment and surgery options. Crosmer is fellowship trained in hand and upper extremity surgery. Regarding UCL tears, the following questions are answered.

1. What is an ulnar collateral ligament tear of the thumb?

  • Ulnar collateral ligament tear of the thumb is when the ligament on the inside portion of the MCP joint of the thumb is torn from the bone. This ligament is important for pinch strength of the thumb. The tear often occurs as the thumb is pulled outward or with a dislocation of the thumb.

2. How is this diagnosed?

  • History and exam are essential for diagnosis. Patients report an injury to the thumb where the thumb is pulled outwards or to the side, often with resulting pain on the inner portion of the thumb and pain with pinching or gripping activities. Swelling is often present. On exam, there is instability on testing of the ligament of the thumb. X-rays are obtained to evaluate for an underlying fracture. An MRI is often ordered to confirm the diagnosis.

3. How is it treated?

  • Partial tears of the ligament can be treated with cast immobilization. Full thickness tears with instability are often best treated with surgery to repair the ligament to its normal position.

4. What are surgical options?

  • If the injury is diagnosed early enough and there is good ligament the ligament can be repaired back to the bone, often with an internal brace which allows a much faster rehab process. If there is not good ligament to repair with ligament is reconstructed with tendon taken from the wrist. (photos attached show repair with internal brace)

5. What is advantage to using Arthrex internal brace?

  • Typically, if repaired without the brace, patients have to wear a cast for 6 weeks after the surgery. This can result in stiffness in the joint. With the internal brace, we can begin range of motion at the joint at 2 weeks after surgery and patients can return to sporting activities after 6 weeks, much faster than traditional repair.

6. Can the Arthrex internal brace be used for other ligament injuries around the wrist and hand?

  • Yes, we are using the internal brace for other ligament injuries around the wrist and hand to allow patients to rehab ligament injuries much more quickly.

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