Skiers Thumb


  • Avulsion of the ulnar collateral ligament of the base of the thumb


  • Usually results from sudden hyper-abduction/extension injury to the thumb either from a fall or tackle situation, when wrapped around a ski pole.


  • Pain is felt on the inside/ulna side of the base of the thumb. There is weakness with pinch grip
  • Examination shows an opening up of the joint with a radial stress.
  • X-rays can show subluxation or opening up of the joint, or a small bony avulsion fragment
  • An MRI scan can help determine the extent of the ligament tear.


  • Grade I and II tears can be treated non-operatively with the use of plasters and splints
  • Grade III tears require surgical intervention to reattach the ligament to the base of the thumb, as it is usually sitting above the adductor aponeurosis (Stennar Lesion)
  • Surgery is done under general anaesthetic and the ligaments reattached to the bone using a bone anchor
  • Chronic tears greater than three months, often require reconstruction using spare tendon of the forearm

Potential Complications

  • Infection, Haematoma, neurovascular injury
  • Stiffness to the MCP joint
  • Ongoing pain in the joint

Post Op Care

  • Patient will awake from surgery in a thumb spica slab
  • Seen at 10 days for removal of sutures and to go into a thermoplastic splint or thumb spica cast for a total of six weeks
  • A strengthening programme for six weeks to three months under the care of the hand therapist.
  • Specialist review at 10 days and six weeks, and three months.
University Of Auckland Auckland Born Joint Surgery Fracs NZOA  University Of Auckland Auckland Born Joint Surgery Fracs