UCL Tear – Skier’s Thumb

What is skier’s thumb?

A skier’s thumb, or ulnar collateral ligament tear, is one of the most common hand injures we treat. These injuries occur from a fall or trauma that forcefully moves the thumb away from the palm. The most common mechanisms are skiing, mountain biking and a fall on the outstretched hand.

The ulnar collateral ligament of the thumb is the most impotent ligament in the hand. It provides stability and strength to the thumb which allows for strong pinch and grasp.

How does Skier’s Thumb occur?

Patients will sometimes hear a pop; notice swelling and see a bump along their thumb. Patients will notice weakness with pinch and grasp and will often drop objects.

Physical exam will show swelling, a bump and pain along the inside of the thumb. The thumb will be unstable, and pinch will be difficult. On X-rays, we may see a fracture associated with the ligament tear, but many times X-rays are negative. MRI may be necessary to make the diagnosis.

Nonsurgical treatment of skier’s thumb

Ulnar collateral ligaments tears can be partial or complete. Complete tears can be displaced or non-displaced. Incomplete and some non-displaced tears can be treated in a splint or cast for 4 weeks and typically heal well. Full activity can be resumed right away with the splint or cast and within 6-8 weeks with no restrictions.

Surgical Treatment for Skier’s Thumb

Displaced and many complete fractures require surgery. The surgery involves reattaching the ligament to bone or fixing the fracture. Current techniques allow for a strong repair. Many patients can resume normal activity like skiing immediately after surgery with a cast or splint and unrestricted activity within 6-8 weeks. Therapy helps strengthen the thumb and long term; normal activity is typical.

Schedule a consultation

Board-certified and fellowship-trained hand surgeon Dr. Kavi Sachar is widely regarded as one the nation’s leading experts on skier’s thumb. Dr. Sachar has three office locations in Vail, Aspen, and Frisco, Colorado. If you or a family member suffer from skier’s thumb, contact Sachar today. Dr. Sachar is part of the world-renowned Steadman Clinic. Dr. Sachar and his team are here to help.