[Skier's thumb injury in the child].

Abstract

Acute rupture of the ulnar collateral ligament (UCL) of the metacarpophalangeal joint of the thumb (skier's thumb) is a common skiing injury in adults. Do we find this injury in children? Of the 302 skier's thumbs during the last 4 years we found 24 (8%) injuries in children (mean age 13.4 years) with open growth plates: 5 partial ruptures of the UCL, 3 Salter I and 6 Salter II fractures with a radial fragment of the proximal phalanx I; all these had conservative treatment. In addition one had a Salter II fracture with open reduction and fixation, 6 avulsion fractures which were treated twice operatively and 4 times conservatively and 3 ruptures of the ligament which needed reconstruction. In contrast to adults, we see a different, age dependent injury pattern in children. The younger had Salter-I- and II-lesions of the proximal phalanx, whereas the adolescents showed avulsion fractures and ruptures of the UCL as seen in adults. The follow-up of 17 patients one year after the accident showed in 12 a full recovery, in 4 cases full function with minor complaints and in one case an ancylosis of the MCP-joint following a postoperative infection.