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Skiers Thumb Injury from a bike fall? do I really need surgery?

post #1 of 5
Thread Starter 



I fell from my road bike about 3 weeks back. I have a small fracture at the base of right thumb. According  to my doctor (Hand specialist) -

the  ligament at the base of my left thumb has pulled away. He suggested I do an MRI ($2500) - to figure out how far the ligament has pulled away. Becos - he said if it is close to the bone - it will fuse itself. Now he says - the MRI results are not totally clear - but he recommends surgery to bring the ligament closer to my thumb - becos if I don't then it could result in instability and loss of strength. And that I should get it done soon.


Fot the first ten days of my injury - I did not even visit the doctor. yes there was pain and swelling but i ignored it. Then i got some x-rays. and then visited the hand specialist. I have been wearing a temporary cast which I can remove. I wear it through out teh day on both my hands  - only removing it at nights.  I ahve been driving, typing, cutting(slowly), holding wine and beer. The right thumb(broken) is in much better shape than the left one. The left thumb (on which he is suggesting surgery) is still weaker than before and is still swollen at the base.


I would like to avoid surgery if possible - to avoid the cost and the hassle. But at the same time I don't want to do anything that could possibily jeopardize my skiing future.


Help! what should I do?



post #2 of 5

First of all, you are asking for medical advice in not the best place. Second, for us who are medical professionals, the amount of information that we have about you and your injury is not enough to give you our input.


But I'll try anyways.


skiiers thumb or gamekeepers thumb  is what we call ulnar collateral ligament injury. It is a ligament which helps you hold onto things with your thumb.



-- Straight from the literature: Inadequately treated injuries or late presenting injuries may lead to chronic instability of the MCP joint, which can result in persistent pain, decreased pinch strength, or degenerative joint changes. ** Arthritis


-- many hand surgeons consider early surgical repair the treatment of choice when patients only experience pain. When there is an avulsion (a bone chip) surgery is highly recommended.


-- There is moderate to high success rates in repair after failed conservative treatment (no surgery).



That all said, if this were me, I'd likely go the conservative route, and if I was still experiencing pain / weakness I would undergo surgery at that time. But your surgeon and you will likely know best for you.


General recs are for conservative management: Total time in splint (3-4 weeks) followed by 2-3 of easy exercise with splint on the rest of the time followed by limited use afterward until pain has completely subsided.


good luck and wish you a speedy recovery.


post #3 of 5
Thread Starter 

Thanks. I appreciate it.

post #4 of 5

Personal experience - I injured my thumb and it killed for a day or two then with ice and not using it, the pain subsided. I didn't have full use, but I didn't worry about it. A year later it started to hurt (insane throbbing), so I went to a hand surgeon. I had a torn ligament and calcium deposits were now building up. An X-ray showed this because of the deposits. I ended up having surgery and it's better but I lost some flexibility and a little strength. I should have had it repaired immediately.

post #5 of 5

I dislocated my thumb while handling a 50 lb weight plate. I had a splint that I wore for 6 weeks and went thru 6 weeks of PT for my "skier's thumb" injury. It's now been 20 years since I injured my thumb. I had about 6 weeks of pain 8 years later that was so bad I considered switching hands I write with but the pain resolved after the hand specialist I saw said it was arthritis. I'd get a second opinion before having a MRI or having hand surgery. I knew a neurosurgeon who broke the base of both thumbs skiing with subsequent ligament tears. He was casted for 6 weeks but did not have surgery, nor was surgery even suggested. Unless you are a neurosurgeon, you probably can get by without surgery. Of the 3 docs I know that had similar injuries, none of us had surgery and we all use our hands. (neurosurgeon, cardiologist, ER doc)

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