Upper extremity injuries in skiing.

Grade III rupture of the ulnar collateral ligament of the thumb is a common injury, especially in skiers. If not treated appropriately, it can lead to symptoms that are quite disabling. The historical methods of diagnosis and treatment have been outlined, and a protocol to accurately establish the diagnosis was suggested. Specifically, vigorous clinical stress testing should not be performed, so that adductor interposition is not created by the testing. Instead, the metacarpophalangeal joint arthrogram is recommended to establish the correct diagnosis, thereby allowing appropriate treatment to be instituted. We recommend casting for Grade III ruptures without adductor interposition and surgical reduction and repair for ruptures with adductor interposition.