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of the Hand & Wrist > Fracture of the Thumb What is Fracture of the Thumb? A fracture of the thumb is a complete or incomplete break in the metacarpal bone, the bone in the lower part of the thumb. A fracture of this bone affects both the joint above the metacarpal and the joint below, the one joining the thumb and wrist. The soft tissue around the fracture site includes nerves, tendons, ligaments and blood vessels, all of which may be affected. Causes of Fracture of the Thumb? Thumb fractures are usually caused by direct stress, often the result of hitting with the fist or catching the thumb on an object. Occasionally a thumb fracture can result from indirect stress, such as from twisting or from violent muscle contraction. The risk of thumb fractures increases with:
While thumb fractures often cannot be prevented, care can be taken during sporting or occupational activities by means of appropriate taping, padding, or protective equipment for the hands and thumb. Developing strength in your hands also helps protect the bones from fracture. Symptoms of Fracture of the Thumb? If you fracture your thumb you will feel severe pain at the fracture site. The soft tissue surrounding the fracture will swell. Motion in the injured site will be limited. If the fracture is complete the bone fragments may separate, making the thumb appear visibly deformed. It will be very tender. If the blood supply is impaired you may experience numbness or coldness in the thumb. Treatment of Fracture of the Thumb? Seek treatment as soon as possible after injury in order to have a doctor assess and limit damage to the thumb. Bleeding and the displacement of body fluids may result in shock after 6 hours if the injury goes untreated. Many tissues quickly lose their elasticity, and this increases the difficulty of returning them to normal. If possible, use a padded splint or sling to immobilize the hand and wrist before going to a doctor’s office or emergency facility. Maintain body heat with blankets or extra clothing to decrease the risk of shock. After examining the injury, taking your history, and evaluating x-rays of the thumb, your doctor will set the broken bone. In most cases, full recovery from a thumb fracture involves surgery. Shaft fractures of the metacarpal can occasionally be realigned without surgery; instead, the bone is fixed in place with a wire across its base. The wire passes through the bone fragment into one of the bones of the hand. Hospitalization may be required for surgery involving anesthesia. Surgical risk increases with smoking and/or the use of drugs, including mind-altering drugs, muscle relaxants, antihypertensives, tranquilizers, sleep inducers, insulin, sedatives, beta-adrenergic blockers, and corticosteroids. Drink only water before manipulation or surgery. After surgery, the thumb and wrist are immobilized with a rigid cast. This cast is generally worn for 3 weeks. Your doctor may prescribe narcotic or synthetic narcotic pain relievers if you are suffering from severe pain. Acetaminophen (available without prescription) helps relieve mild pain after initial treatment. Contact your doctor if you experience any of the following after treatment: increased pain, swelling or drainage in the surgical area, signs of infection (headache, muscle aches, dizziness, fever, or a general ill feeling), swelling above or below the cast, blue or gray color to the skin beneath the fingernails or thumb, numbness or the loss of sensation anywhere in the hand, nausea or vomiting. Follow your doctor’s instructions carefully. He or she may recommend that after 48 hours you regularly apply localized heat to the injury through the cast using a heat lamp or heating pad. At this point heat promotes healing by increasing blood flow to the injury. Actively exercise all muscle groups that are not immobilized. Muscle contractions in these parts of the hand and arm promote future alignment and aid the healing process. Eat a well-balanced diet that includes extra protein such as meat, fish, poultry, cheese, milk, and eggs. After the cast is removed ice massage also helps heal the thumb tissue. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top of the cup so that ice protrudes, and massage firmly over the injured area. Your doctor will tell you when to begin reconditioning the thumb and hand, and will provide you with rehabilitation exercises. Use ice massage for ten minutes prior to exercise. Follow directions for R.I.C.E.:
The information provided herein is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting a licensed physician. © 2000 DynoMed.com, LLC, Indianapolis, IN |