SKIER THUMB IN CHILDREN

Acute rupture of the ulnar collateral ligament (UCL) of the metacarpop halangeal 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 thu mbs during the last 4 years we found 24 (8%) injuries in children (mea n age 13.4 years) with open growth plates. They had the following diag nosis and consecutive treatment: 5 partial ruptures of the UCL, 3 Salt er I and 6 Salter II fractures with radial fragment of the proximal ph alanx I; all these had conservative treatment. In addition one had a S alter III fracture with open reduction and fixation, 6 avulsion fractu res, which were treated twice operatively and 4x conservatively and 3 ruptures of the ligament which needed reconstruction. Supposing the tr auma mechanism in adults, we see a different, age-dependent injury pat tern in children. The younger had Salter-I- and Salter-II-lesions of t he proximal phalanx, where as the adolescents showed avulsion fracture s and ruptures of the UCL as seen in adults. The follow-up of 17 cases minimally 1 year after the accident showed in 12 a full recovery, in 4 cases small subjective symptoms but full function and in 1 case an a ncylosis of the MCP-joint following a postoperative infection.