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A thumb fracture can come in various degrees of severity, ranging from a simple, easily treatable break to more complex injuries involving multiple fractures along the joint that may require surgery. As thumb injuries can affect many aspects of life—from eating to work capacity—it is important to take this issue seriously. Understanding the symptoms of a thumb fracture and the available treatment options is crucial for recovery.
Steps
Identifying a Thumb Fracture
Severe Pain. After a thumb fracture, you typically experience intense pain, which is normal because the bone is surrounded by nerves. The fracture can irritate or press on these nerves, causing pain. If you do not feel much pain after the injury, it is less likely that the thumb is fractured.
- Pain can also be felt if something touches the thumb or when attempting to bend it.
- Generally, the closer the pain is to the joint where the thumb meets the rest of the hand (near the flesh between the thumb and index finger), the more concerning it is, with a higher risk of complications.
Look for signs of deformation at the site of injury. Carefully check if the thumb appears normal. Is it bent or twisted abnormally? Additionally, check if any bone fragments are protruding from the skin. If any of these signs are present, it is almost certain that the thumb is fractured.
- A common indication of a thumb fracture is bruising, which signifies broken capillaries in the tissue.
Try moving the thumb. If the thumb is fractured, attempting to move it will cause severe pain. The ligaments attached to the bone will no longer function properly, making it difficult to move the thumb.
- It is especially important to test whether you can move the thumb backwards. If you can do so without experiencing pain, it is more likely you have a sprain rather than a fracture.
Pay attention to numbness, tingling, or coldness in the thumb. In addition to pain, pinched nerves may cause the thumb to feel numb or cold. This happens because the broken bone or swelling can compress blood vessels, blocking blood flow to the thumb and surrounding tissues.
- The thumb may turn blue if it is not receiving enough blood or if blood cannot return to the area.
Look for swelling around the thumb. When a bone fractures, the surrounding area swells due to inflammation. The thumb usually begins to swell within five to ten minutes after the injury occurs. It will also start to feel stiff.
- The swelling in the thumb may also affect nearby fingers.
Ask a Doctor to Assess the Injury
Seek medical attention or go to the emergency room. If you suspect your thumb is fractured, it is important to visit the emergency room for proper evaluation by a specialist. Waiting too long can make it difficult to realign the bone due to swelling, and if the fracture cannot be set properly, your thumb may remain permanently deformed.
- In children, a thumb fracture can have long-term effects on the growth of the thumb, as the growth plate cartilage may be damaged.
- Even if you suspect a simple sprain (ligament tear), it is advisable to seek medical attention for an accurate diagnosis. In some cases, severe sprains also require surgical intervention. Generally, it is best to let a medical professional determine the diagnosis and treatment.
Physical examination. In addition to asking about symptoms as outlined in Part One, the doctor will perform a physical examination of the thumb. They will test the strength and range of motion of the thumb by comparing it to the uninjured thumb. Another test involves touching the tip of the thumb to the index finger and applying pressure to check for weakness in the thumb.
X-ray the thumb. The doctor may order X-rays of the thumb from multiple angles. This will not only confirm the diagnosis but also reveal the number of fractures, which is essential for determining the appropriate treatment options. Common X-ray views include:
- Lateral view: The hand is placed on its side so that the thumb is on top.
- Oblique view: The hand is placed on its side with a slight tilt so that the thumb is on top.
- AP (anteroposterior) view: The hand is placed flat and the X-ray is taken from above.
Ask your doctor about a CT scan (Computed Tomography). A CT scan, sometimes referred to as a CAT scan, uses X-rays and a computer to create detailed images of the inside of the body (in this case, the thumb). This imaging helps the doctor understand the fracture better and determine the most effective treatment.
- If you are pregnant, be sure to inform your doctor as CT scans can pose risks to the fetus.
Have your doctor diagnose the type of bone fracture. After completing all necessary tests, the doctor will identify the type of fracture, which will determine the complexity of the treatment approach.
- Extra-articular fracture: This occurs when the fracture is located away from the joint along one of the two bones of the thumb. Though very painful and requiring up to six weeks to heal, this type usually does not require surgery.
- Intra-articular fracture: This type involves the joint and often requires surgery to restore maximum joint function.
- Among intra-articular fractures, the two most common types are Bennett's fracture and Rolando's fracture. In both cases, the thumb is fractured (and may also be dislocated) at the carpometacarpal joint (the joint closest to the hand). The main difference is that a Rolando fracture involves three or more pieces and always requires surgery, while a Bennett fracture may sometimes not require surgery.
Treatment for Thumb Fracture
Consultation with an orthopedic specialist. Based on X-ray images and test results, the orthopedic doctor will determine the most suitable treatment method. They also evaluate the type of fracture (intra-articular or extra-articular) and the complexity of the fracture (whether it's a Bennett or Rolando fracture).
Consider non-surgical treatment options. For simple fractures (like extra-articular fractures), the doctor may manually realign the fractured bone without the need for surgery. They will administer a local anesthetic before performing the realignment.
- This method (known as closed reduction) involves the doctor gently pulling the bone along the fracture line to reposition it, while using fluoroscopic guidance (real-time X-ray) to observe the bone during the procedure.
- In some cases of Rolando fractures, especially when the bone is broken into multiple interlocking pieces, the surgeon might use this technique as well, which is called open reduction, where they work to carefully realign the bone fragments.
Consider surgical treatment. For fractures within the joint (such as Bennett and Rolando fractures), orthopedic surgeons typically recommend surgery. The specific surgical approach will depend on the complexity of the fracture. Common surgical options include:
- Using fluoroscopic guidance to insert a metal pin through the skin to realign the bone fragments, known as external fixation. This method is generally used for Bennett fractures where the bone fragments are still relatively close to each other.
- The surgeon may perform an open surgery on the hand to insert small screws and pins to hold the bone fragments in place, known as internal fixation.
- Potential complications from surgery include nerve or ligament damage, stiffness, and an increased risk of developing arthritis.
Thumb immobilization. Whether or not surgery is needed, the doctor will apply a cast to stabilize the thumb and keep the bone fragments in place during recovery.
- You will likely need to wear the cast for anywhere from two to six weeks, typically closer to six weeks.
- You will also need to follow up with the doctor for several checkups during this period.
Consult with a physical therapist. Depending on how long you need to wear a cast and your level of mobility once the cast is removed, your doctor may recommend that you meet with a physical therapist or an occupational therapist. They will guide you through exercises to bend and grasp objects, helping you regain strength in areas where muscle wasting occurred during the immobilization period.
Advice
- Whether you have a bone fracture or a sprain, it is always recommended to visit a hospital for medical care.
Warning
- This article provides medical information regarding thumb fractures, but it should not be regarded as professional advice. Always consult a doctor for an accurate diagnosis and the most suitable treatment for your injury.
- If you are pregnant, inform your doctor before undergoing an X-ray. The fetus is very sensitive to X-rays, so it is best to avoid using this method to determine if your thumb is fractured.
