Skier's Thumb (cont.)
Skier's Thumb Diagnosis
The physician will first determine whether or not the patient has other limb-threatening injuries and then evaluate the thumb in more detail.
The doctor will ask the patient how the injury happened. The patient will be asked the following questions:
- At what time did the injury take place?
- What was the exact positioning of the hand and thumb during the injury?
- How soon after the injury did the pain and swelling begin?
- Did it feel as if the thumb was stressed beyond its normal range of motion?
The doctor will also ask about the patient's past medical history. The patient will be asked the following questions.
- Have you ever suffered from a similar injury before?
- Have you ever had any type of surgery in your hand or wrist?
- Are you allergic to any pain medications?
- Have you ever fractured any bones in your wrist or hand?
- Are you right-handed or left-handed?
- What is your primary occupation?
The doctor will then perform a physical examination.
- Testing the laxity (looseness) of the ulnar collateral ligament of the thumb: This test will be done by holding the base of the thumb in a fixed position, while applying a lateral (sideways) force on the tip of the thumb to see how many degrees it will move. This movement will be compared to the movement of the other, uninjured thumb. Pain may make this difficult to do immediately after the injury (in which case the injury may be treated and then reexamined in a few days).
- Assessing for normal functioning of the three major nerves in the hand
- Checking for point tenderness over certain bony spots of the hand that may indicate fracture
- X-ray of the hand to make sure no bones are broken
- Examining the rest of the arm for any associated injuries to your wrist, forearm, elbow, and shoulder
Skier's Thumb Self-Care at Home
If you suspect that you may have a skier's thumb, then home care should address the pain and swelling of the thumb. Take the following steps to minimize your pain and swelling.
- Apply ice to the thumb for 35 minutes at a time, up to four times per day. Do not apply ice directly to the skin. Continue to use ice until the pain stops. (A doctor should be seen as soon as possible after the injury and then follow a doctor's directions for ice therapy.)
- Avoid movement of the thumb as much as possible. The loose application of an ACE wrap or commercially available wrist brace in the neutral position will help immobilize the thumb. This will help lessen the pain.
- Take acetaminophen for pain relief or ibuprofen for anti-inflammatory action. Avoid both of these over-the-counter drugs if you have stomach problems and cannot tolerate them.
- The most important aspect of home care is to ensure that the injury is fully evaluated by an emergency doctor, orthopedic surgeon, or a primary care physician in the first few days.
Medically Reviewed by a Doctor on 3/25/2016
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