I injured my thumb when skiing. What is the prognosis?

Q. I was skiing last week when I fell and my thumb was snapped sideways as I landed on my ski pole. I felt a pop and had severe pain. At the emergency room, I was told nothing was broken, although I had a bad sprain. A splint was applied to my thumb and I was instructed to see an orthopedic surgeon when I returned home to Miami. The doctor in Miami diagnosed my injury as a skier’s thumb and surgery was recommended. My thumb still is swollen and feels weak when I try to grip. I really do not want surgery and wonder if there are any other treatment options?

A. Skier’s thumb is an injury to the ulnar collateral ligament, which is a major stabilizer of the thumb. This injury usually occurs when the thumb is abruptly snapped outwards.

In addition to skiing, this injury is common in basketball and football. A complete tear of this ligament can result in an unstable thumb that is painful and weak while lifting or gripping objects.

An MRI scan can be helpful in assessing the severity of the ulnar collateral ligament tear. The orthopedic surgeon or hand specialist may also recommend special stress X-rays of the thumb ligaments to help confirm the degree of instability.

Mild injuries can be successfully treated with a cast or splint. Complete tears of the ulnar collateral ligament usually require surgery to achieve a stable and functional thumb.

Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send your questions to HarlanS@baptisthealth.net