THUMB FRACTURES

Trauma Conditions Fractures Thumb Fractures

The thumb serves as an important tool of the hand, creating a pinch action against the four digits. This unique function of the thumb is because the base of the thumb rides on the trapezium (a saddle joint), allowing it to circumduct or rotate. The trapezium bone is located at the base of the thumb, and it articulates with the first metacarpal bone (the bone of the thumb) and other carpal bones. This joint allows for the movement and flexibility of the thumb. The trapezium is an important part of the wrist and hand anatomy, as it plays a crucial role in thumb mobility and function. The thumb is stabilised at the base of the trapezium by multiple intricate ligaments and is, therefore, very strong.

The metacarpophalangeal joint is more at risk for injury as it has less ligamentous support than the base of the thumb joint (carpometacarpal joint). The most common injury of the thumb is a tear of the ulnar collateral ligament of the metacarpophalangeal joint, which will be dealt with in a separate section.

The thumb is commonly fractured, as it is exposed to the manual risk of crush-type injuries as well as multiple other combinations of the wrist and other trauma to the thumb. A common injury of the thumb is a metacarpal fracture. This is usually when high energy forces apply to the thumb, i.e. a fall, landing on the thumb, or clenching the thumb in a fist motion. A base of the thumb fracture usually extends into the joint (an intra-articular fracture).

A very complicated fracture pattern at the base of the thumb metacarpal is a Rolando fracture, where there is a Y-format fracture at the base of the thumb with intra-articular involvement as a result of a ligament tear. This fracture will require a surgical fixation.

The proximal and distal phalanx towards the tip of the thumb are also at risk of direct trauma. The distal phalanx under the nail is commonly fractured in crush injuries of the thumb.

Treatment

The treatment of thumb fractures is to maintain or restore perfect anatomical reduction with immobilization for five to six weeks to facilitate the healing and bone union. If the fracture is displaced, we need to surgically fixate the fracture with a plate and screws and then start early movement of the thumb, while still protecting it with a splint for four to six weeks. Crush-type injuries on the tip of the thumb and the nail bed will need to be surgically repaired.

FAQ

1Are thumb fractures serious?
A broken thumb can limit hand mobility and function.
2Is a thumb fracture very painful?
A broken thumb can cause swelling and pain in the thumb.

Please read the above text for more in-depth information to help answer these questions. It's important to consult with our qualified healthcare professionals to ensure the appropriate diagnosis and treatment plan for your specific situation.

Post-operative fixation of a thumb fracture

Anatomical X-ray of the thumb

Rolando type fracture before surgery

Rolando type fracture after surgery