Gamekeeper's thumb

Abstract

The term gamekeeper's thumb is widely used interchangeably with skier's thumb in reference to acute or chronic tears of the ulnar collateral ligament of the thumb MCP joint. The frequency of thumb injury in alpine skiing has not changed with recent changes in pole design. Release of the pole from the hand prior to impact with the ground will minimize injury. Arthrogram may be a useful adjunctive technique to identify the presence of a Stener lesion and strengthen the indications for surgery in borderline cases. The sensitivity and specificity of this test have not been established. Current trends favor acute surgical repair for complete tears of the ulnar collateral ligament of the thumb MCP joint as documented by clinical examination with stress radiography. Good results are obtainable with late reconstruction, and comparable results have been noted with the most commonly used techniques.