If the ligament is torn off the bone, surgical treatment would likely include operative exploration and ligament repair using a suture anchor. “The torn area is exposed, then cleaned of any remnant tissue,” Dr. Donnelly says. “The bone is usually scuffed up to create a more ideal surface for ligament healing. Then an anchor which is akin to a dry-wall molly bolt with sutures attached is used to repair the ligament back to bone.”

With both partial and complete injuries, the ligament requires about six weeks to heal. But that doesn’t mean Brees would be immediately cleared to play. “In partial injuries, there is some ligament still intact stabilizing the joint – which is not the case in complete tears,” Dr. Donnelly says. “Return after partial injury is variable depending on how severe the partial injury is. However, the ligament is not at its full strength until three to four months out from injury.”

Although unlikely to be Brees’ injury, as we have not heard it mentioned, another possible variant of this skier’s thumb injury is to have a fracture of the thumb bone.

Another possible variant of this skier’s thumb injury is to have a fracture of the thumb bone – although this is unlikely to be Brees’ injury, since we have not heard it mentioned. We call this a ligament avulsion fracture and is quite common occurring at the base of the proximal phalanx, where the thumb meets the hand: “Sometimes, the ligament is stronger than the bone itself. And when enough pressure is applied, the bone can fracture. The ligament essentially tears a little piece of bone off with it.”

A ligament avulsion fracture would change both the treatment plan, and potential recovery time. “If there is a fracture instead of a ligament tear, depending on how big the fracture bone is, the repair is different,” Dr. Donnelly confirms. “Avulsion fractures are often fixed with screws, while pure ligament tears are fixed using anchors to reattach the ligament back down to the bone. Sometimes, pins are used to reinforce a repair method, but are usually temporary for a few weeks or so.” The advantage of an avulsion fracture versus a complete tear is bone to bone healing occurs more quickly than ligament to bone. Evaluation of healing is easier as well using standard radiography and CT imaging.