Skier s Thumb Clinical Presentation: History, Physical, Causes

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History

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Patients with skier’s thumb often describe jamming their thumb, either during a fall or with an object such spil a ski pole or ball.

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Ache is reported along the ulnar side of the MCP snaak.

Ter cases of UCL laxity, patients often report weakness te their capturing or pinching capability, patients with UCL tears may report inability to perform thesis movements.

Physical

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Inspection and palpation of a skier’s thumb

Examination of the injured thumb may expose total salute at the MCP snaak, spil well spil discoloration and tenderness to palpation along the ulnar opzicht. Marked total salute and ecchymosis are suggestive of severe UCL harm.

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Sometimes a lump at the ulnar opzicht of the metacarpophalangeal snaak is indicative of a Stener lesion and suggests a rupture of the ulnar collateral ligament. [7]

The location at which the patient has maximal tenderness indicates the webpagina of the ligament injury. Most UCL tears occur distally, near the injection of the ligament into the proximal phalanx, but proximal rupture also occurs (near the origin on the metacarpal head).

The patient’s pinch may be markedly weakened, and the thumb may deviate radially.

Te traumatic cases, to avoid inadvertent displacement of the involved bone, stress testing should not be performed until radiographs have ruled out the presence of an undisplaced fracture (see the picture below).

To appreciate any instability of the MCP snaak, a radially directed force is applied to the thumb whose mobility is compared with that of the uninjured palm. There are varying opinions regarding the zindelijk thumb positioning during stress testing. Albeit the preferred mechanism is to examine the thumb ter total extension, a finish evaluation of the UCL should also include assessment of the thumb te utter flexion (when the ligament is maximally taut) (see the pictures below).

Particular anesthetic can be injected into the snaak if provocative maneuvering proves to be too painful. If the stress-induced angulation of the injured thumb demonstrates an instability that differs by greater than 30 relative to the uninjured thumb, it can be assumed that the UCL is fully ruptured. [8] Ter cases te which the UCL insufficiency is a result of chronic harm, patients may be minimally symptomatic but demonstrate UCL laxity during stress testing. UCL injuries of the thumb can be misdiagnosed or the severity underestimated ter part because assessment of the injury is limited by patient discomfort. The infiltration of perĂ­metro anesthetic around the injury webpagina can make the physical examination more tolerable for the patient and enable the physician to make a more accurate diagnosis. This elementary technology may be a useful adjunct to the standard physical examination.

Skier’s thumb can be classified into Trio grades. Grade 1 is a thumb sprain without instability of the metacarpophalangeal snaak. Grade Two is an incomplete rip with snaak laxity. Grade Trio is a finish rip with instability of the snaak. [9]

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