One of the more common sports injuries during the ski season
is injury to the thumb. This is most often a result of falling
directly on the outstretched thumb, or because of ski pole
position. When an individual falls, the thumb is often hyperdeviated
(bent away from the normal thumb range of motion). This causes
stress across the ligaments of the main thumb joints, causing
them to either stretch or tear. Occasionally the bone gives
way, resulting in a break or fracture. The above x-ray picture
shows a dislocation and fracture of the thumb-hand joint.
What to do if you suspect such an injury? The thumb and index
finger are your most important digits as they are required
for pinching and many fine motor skills. Poor healing of this
type of joint injury can lead to long-term disability, especially
if it involves your dominant hand. Initial treatment should
involving immobilizing the joint with some type of splint,
analgesics, elevation and ice to reduce swelling and pain.
The injury should be evaluated by a medical practitioner and
frequently requires an x-ray. For minor sprains, several days
of splinting is always required, followed by a week or so
of limited non-stress use of the thumb. For more serious injuries
that involve a bone or complete ligament rupture, surgical
repair is often needed to optimize healing and functional
outcome.
Todd H. Chaffin, M.D.
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