Skier's thumb is a partial or complete rupture of the ulnar collateral ligament of the metacarpophalangeal joint of the thumb. It is an injury that rather frequently occurs in certain sports. When diagnosed incorrectly, delay in treatment can ultimately lead to chronic instability and pain. Correct knowledge of the anatomy and method of physical examination is essential when assessing a patient suspected of having skier's thumb. This article describes three different types and treatment of skier's thumb, and further describes the relevant anatomy, correct physical examination, available additional imaging and various treatments possible.
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Background: There is debate regarding nonoperative versus surgical treatment of thumb ulnar collateral ligament (UCL) tears with avulsion fractures. The aim of this study was to evaluate the fragment size in relation to the UCL footprint size in patients with an avulsion fracture injury and to find risk factors associated with surgical treatment.
Methods: In a cohort of avulsion fracture injury patients, the largest side of the fragment was divided by the average reported UCL footprint size (ff-ratio), and a logistic regression was performed to find variables associated with surgery.
Three rare cases of two-level skier's thumb injuries-review of the literature, anatomical variants and surgical treatment.
Case Reports Plast Surg Hand Surg
December 2024
Clinic for Hand Surgery, Cantonal Hospital Graubünden, Chur, Switzerland.
We report three rare cases of two-level skier's thumb injuries and explain the diagnostic challenges, surgical treatments, and anatomical explanations to emphasize the importance of a systematic diagnostic approach in every skier's thumb injury, including clinical examination, radiography, and ultrasonography. A surgical method to treat these rare cases is presented.
View Article and Find Full Text PDFStudy protocol for a multicenter non-inferiority randomized controlled trial to assess functional outcomes and cost-effectiveness of a primarily non-operative treatment strategy with cast immobilization versus immediate operative treatment followed by cast immobilization for patients with complete ulnar collateral ligament ruptures, including Stener lesions: MUSCAT study.
Trials
October 2024
Department of Trauma Surgery, Diakonessenhuis, Utrecht, The Netherlands.
Article Synopsis
- Guidelines recommend surgery followed by casting for UCL ruptures, but high-quality studies comparing surgical and non-surgical treatments are scarce.
- This study aims to investigate if non-operative treatment with cast immobilization is just as effective and less costly than immediate surgery for these injuries.
- The trial includes patients over 18, comparing outcomes between two groups over six months, with a focus on hand function and the potential need for follow-up surgery.
A Surgical Approach to a Thumb Metacarpophalangeal Joint Ulnar Collateral Ligament Injury without Dividing the Adductor Aponeurosis.
J Hand Surg Asian Pac Vol
October 2024
Department of Orthopaedic Surgery and Traumatology, University Hospital of Ghent, Belgium.
Article Synopsis
- A common injury known as skier's thumb involves tearing the ulnar collateral ligament (UCL) at the thumb's metacarpophalangeal joint (MCPJ).
- The traditional surgical method requires cutting through the adductor aponeurosis to repair the torn UCL and MCPJ.
- This text presents a new surgical approach that avoids cutting the adductor aponeurosis during UCL repair.
Patient-Reported and Clinical Outcomes After Tendon Autograft Reconstruction of the Thumb Ulnar Collateral Ligament.
J Hand Surg Am
June 2024
Department of Plastic, Reconstructive and Hand Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands.
Article Synopsis
- A study was conducted to evaluate clinical outcomes and patient-reported experiences following thumb ulnar collateral ligament (UCL) reconstruction using a tendon autograft from December 2011 to February 2021.
- Results showed that patients' Michigan Hand Outcomes Questionnaire (MHQ) scores significantly improved over 12 months, indicating better pain management and hand function post-surgery.
- Although most patients experienced stability restoration, those with ongoing instability or diagnosed metacarpophalangeal arthritis had limited improvement in their outcomes, emphasizing the complexity of healing in such cases.
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