MANUAL MINORS
Thumb fractures occur when one of the two bones of the thumb, the proximal or distal phalanx, or the first metacarpal, breaks due to direct trauma, such as a fall or blow. This type of fracture can significantly impair hand function, as the thumb is essential for gripping and manipulating objects.
Diagnosis
Diagnosis is based on trauma history, with symptoms such as sharp pain, swelling, deformity, and difficulty moving the thumb. X-rays confirm the type and location of the fracture, guiding appropriate treatment decisions.
Differential Diagnosis
Condition | Key Differences |
|---|---|
Thumb dislocation | Visible deformity and joint displacement without a fracture line on X-rays. |
Collateral ligament sprain | Localised pain in the ligament without displacement or fracture on X-rays. |
Extensor tendon rupture | Difficulty extending the thumb without visible fracture. |
Thumb arthritis (rhizarthrosis) | Chronic pain, stiffness, and degenerative changes in the carpometacarpal joint, without recent trauma. |
Emergency Management
Immediate immobilisation of the thumb with a splint or cast to prevent further displacement of the fracture.
Administration of analgesics and anti-inflammatory medications for pain control.
If the fracture is displaced or unstable, perform a closed reduction under local anaesthesia.
Post-reduction X-rays to confirm proper alignment of bone fragments.
Urgent referral to a hand specialist if the fracture involves the joint or if there is significant displacement.
Definitive Treatment
Definitive treatment depends on the type of fracture:
Non-displaced fractures: Managed with immobilisation in a cast or splint for 4-6 weeks.
Displaced or unstable fractures: Such as Bennett’s fractures (fracture at the base of the first
metacarpal), may require surgical intervention for fixation with screws or plates.
Post-treatment, physiotherapy is recommended to restore thumb mobility and strength.
Comments