Skier’s Thumb

The joint that is affected is called the metacarpophalangeal (MCP) joint. Any hard force on the thumb that pulls it away from the hand can cause damage to the ligaments. When the thumb is straight, the ligaments are tight and so stabilise the joint against any force. If the force is too strong however, these ligaments can tear causing the MCP joint to become very unstable.

If the ligaments have completely torn, surgery may be required. The operation involves making a small cut over the back of the MCP joint of the thumb. After exposing the MCP joint and the ligaments, the area around the injury is examined for any soft tissue damage. Your surgeon will then repair the ligaments with stitches/ a bone anchor that anchor them back to the bone.

Your hand will be placed in a bulky plaster bandage. To avoid swelling and throbbing, you should keep your hand elevated for the first few days. Your stitches will be removed after 10 to 14 days by the hand therapist, and your finger/hand will be placed in a thumb spica cast for up to six weeks. When the cast is removed after six weeks, you may have stiffness in the thumb joints. You may require further hand therapy to improve hand function.

You may drive after six weeks if you feel safe to do so. You may begin light duties after six weeks and most patients can return to normal activity after 3 months.

Generally, this procedure is considered to be effective and low risk. However some people may have problems. The commonest of this is tenderness of the scar, which is usually temporary and is helped by scar massage. You could have numbness in the thumb which usually subsides. The range of movements in the MCP joint could be reduced due to scarring of repaired tendon. Other problems are swelling and stiffness of the hand, which if severe is called reflex sympathetic dystrophy and is rare. Infection is also rare. Occasionally, the repaired/reconstructed ligament can stretch out causing pain in the joint with instability.