A thumb fracture is a crack or break in one or more of the bones in your thumb. A direct blow, such as a fall, can cause a thumb fracture. It can also happen when your thumb is twisted, pulled back, or bent with force. A broken thumb is a serious problem. It affects the ability to grasp items. A broken thumb can increase the risk of arthritis later in life.
Although a break can occur in any of these bones, the most serious breaks happen near the joints. This is particularly true when the fracture occurs at the base of the thumb near the wrist.
Thumb fractures are usually caused by direct stress, such as from a fall. A thumb fracture may happen when a ball catches and pulls the thumb back. Some fractures may be caused indirectly, from twisting or muscle contractions, as in such contact sports as wrestling, hockey, football, and skiing. People with a history of bone disease or calcium deficiency are especially at risk.
The risk of a thumb fracture can be lessened by using protective taping, padding, or other equipment. Developing strength in the hands through exercise and proper nutrition can also provide some protection.
There are specific types of thumb fractures, depending on the type of break. Bennett and Rolando fractures are breaks at the base of the thumb. They involve the joint between the thumb metacarpal and a specific wrist bone. Fractures that involve the joints are always more difficult to treat and are at increased risk of an unfavorable outcome.
• Severe pain at the fracture site
• Limited or no ability to move the thumb
• Extreme tenderness
• A misshapen or deformed look to the thumb
• Numbness or coldness in the thumb
A doctor should be consulted as soon as possible. Continued swelling may make it more difficult to align the bones properly. Delayed treatment will make the fracture much more difficult to treat and can lead to a poor outcome. A padded splint can be used to prevent the bone from moving farther out of alignment. This is encouraged before treatment is finalized.
The physician will examine the injury, take a medical history, and order X-rays of the injury.
• X-ray: This checks for fractures in your thumb
• This test is also called a CAT scan. An x-ray machine uses a computer to take pictures of your thumb. The pictures may show ligament or tissue damage. You may be given a dye before the pictures are taken to help caregivers see the fracture better. Tell the caregiver if you have ever had an allergic reaction to contrast dye.
• Pain medicine: You may be given a prescription medicine to decrease pain. Do not wait until the pain is severe before you take this medicine.
• Cast or splint: You may need a cast or splint to keep your thumb in the correct position as it heals.
• Closed reduction: Your caregiver may need to move the bones of your thumb back into their correct positions. He presses on your hand and thumb to line your bones up without surgery.
• Surgery: You may need surgery if you have a severe thumb fracture or it does not heal after other treatments:
o External fixation: Your caregiver will put pins or screws through your skin to straighten and hold your bones in place. The screws may be secured to a metal device that wraps around your thumb to hold it in place.
o Open reduction and internal fixation: Your caregiver will make an incision in your thumb to straighten your broken bones. He may use wires, screws and metal plates, or pins to hold your broken bones together.