Base of Thumb Fractures

Thumb Spica/Casts Elevation of the Limb

Initial Management

  1. Base of thumb fractures can present similar very similar to scaphoid fractures and wrist/scaphoid fractures should be considered.
  2. Axial compression of the thumb will be very painful in base of thumb fractures.
  3. Request AP and Lateral and pronated oblique views of the thumb, focussing on the first metacarpal.
  4. Irrespective of the management plan, all base of thumb fractures can be immobilised in a thumb spica, which is a half cast immobilising the wrist and the thumb to the level of the interphalangeal joint. See splinting guideline.

X-Ray Guideline

Four types of fractures are commonly seen at the base of the first metacarpal:

Extra-articular transverse or oblique fractures

Definitive Management

Base of Thumb Fractures Thumb Fractures

Rehabilitation by hand therapist post surgery