Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Skier’s Thumb

SYMPTOMS

There is pain and swelling over the ulnar aspect of MCP I after getting stuck or from a direct impact to the thumb during a fall. These
symptoms are caused by rupture of the ulnar collateral ligament at the MCP I with or without  avulsion of a bony fragment.

CLINICAL FINDINGS

There is localised tenderness on palpation and inability to stabilise the MCP joint in an ulnar deviation test. Stener’s complication results in soft tissue impinging into the joint, blocking the ligament from healing to the bone.

INVESTIGATIONS

X-ray may verify an avulsed bony fragment.

TREATMENT

A stabilising bandage, brace or strapping should be applied. Surgery for repair of the ulnar ligament is usually required, followed by
six weeks’ immobilisation and physiotherapy.

REFERRALS

Refer to Dr Kevin Yip (+65 9724 1219) senior consultant orthopaedic surgeon and hand specialist  if this diagnosis is suspected
or if the diagnosis is not clear.

EXERCISE PRESCRIPTION

Most sports can be maintained during healing. After surgery the symptoms are usually relieved almost immediately and most activities can be back to normal within six weeks. Running, cycling and water exercises (when the wound is healed after surgery) are good alternatives to keep up general fitness. Gym training can be maintained.

EVALUATION OF TREATMENT OUTCOMES

Normal clinical symptoms and signs and good hand function. Compare with other hand.]

DIFFERENTIAL DIAGNOSES

This is a clear clinical diagnosis but is still often missed.

PROGNOSIS

Excellent, if treated appropriately. If it is missed, surgery can be performed at a later stage.

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