What does it feel like?
Patients often describe an ache or pain in the thumb, at the thumb metacarpophalangeal joint, which is located at the level of the 1st webspace, where your thumb joins the palm. Sometimes patients describe a feeling of not being able to ‘trust’ their thumb when attempting to pinch or grip an object between their thumb and index finger.
What is it?
It is an injury to the ligament that stabilises the thumb metacarpophalangeal joint. This particular ligament is located on the side of the thumb that faces the index finger. The purpose of the ligament is to hold the two bones of the joint, the proximal phalanx and the metacarpus, together against a force applied to the thumb.
What causes it?
Trauma, such as falling onto the thumb, or a sudden forceful wrenching of the thumb outwards, is the most common cause of skier’s thumb. The term skier’s thumb refers to how the injury is sustained when a ski pole becomes unexpectedly stuck in the snow while being grasped, leading to the thumb to be jerked away from the rest of the hand which is still being propelled forwards.
What are my treatment options?
This depends on the degree of severity in the injury. Where the ligament is sprained and not avulsed off bone, non-operative management with hand therapy is an excellent option. This involves a thermoplastic splint that is custom-made for you, and should be worn between 6-8 weeks in total, depending on the nature of the sprain.
In complete avulsion injuries, surgery is usually the mainstay of treatment. Surgery involves repairing the ligament back to the bone from which it has avulsed. Following surgery, the thumb will need to be protected while the ligament repair strengthens and heals with time, and this will require the involvement of a hand therapist who will custom make a splint and prescribe rehabilitative exercises