Ulnar Collateral Ligament Tear of the Thumb: (Ski Pole, Skier’s, or Gamekeeper’s Thumb)

Presentation

The patient fell while holding on to a ski pole, banister, or other fixed object, forcing the thumb radially into abduction and causing pain at the base of the thumb. The metacarpophalangeal (MCP) joint of the thumb is swollen and tender and may be ecchymotic. When tested for stability, it may show varying degrees of joint widening toward the radial (or palmar) aspect more than the MCP joint of the other thumb. The patient’s power pinch between the thumb and index finger, if possible at all, is less strong than with the other hand ( Fig. 132.1 ).