Thumb Fracture

A complete or incomplete break in the metacarpal bone of the thumb.

Body Parts Involved

• Metacarpal bone of the thumb.
• Joint between the two longer bones of the thumb, and joint between the lowest bone of the thumb and the wrist.
• Soft tissue around the fracture site, including nerves, tendons, ligaments and blood vessels.

Causes

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:

• Contact sports such as hockey
• Skiing
• A history of bone or joint disease, especially osteoporosis
• Poor nutrition, especially calcium deficiency

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.

Signs & Symptoms

• Severe thumb pain at the fracture site.
• Swelling of soft tissue around the fracture.
• Visible deformity if the fracture is complete and the bone fragments separate enough to distort the thumb.
• Tenderness to the touch.
• Numbness or coldness in the thumb, if the blood supply is impaired.

Treatment

Follow directions for R.I.C.E. :

• Rest the injured area as much as possible.
• Ice the injury as recommended.  This reduces blood flow and limits swelling and internal bleeding.
• Compress the injured joint according to your doctor's instructions.
• Elevate your hand to help control swelling.

First Aid

• Use a padded splint or sling to immobilize the, hand and wrist before taking the injured person to the doctor,s office or emergency facility.
• Keep the person warm with blankets to decrease the possibility of shock.
• The doctor will set the broken bones with surgery or, it possible, without. This
  manipulation should be done as soon as injury. Six or more hours after the fracture, bleeding and displacement of body fluids may lead to shock. Also, many tissues lose their elasticity and become difficult to return to a normal position
• Shaft fractures of the metacarpal can sometimes be realigned without surgery, but the broken bones must be fixed in place with a wire across the case of the metacarpal bone. This wire passes through the bone fragment into one
  of the hand.

Continuing Care

• Immobilization will be necessary. A rigid cast is used to immobilize the thumb and wrist. This cast can usually be removed in 3 weeks.
• After 48 hours, localized heat promotes healing by increasing blood circulation in the injured area. Use a heat lamp or heating pad so heat can penetrate the cast.
• After the cast is removed, use frequent ice massage. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage firmly over the injured area.

Medication

Your doctor may prescribe:

• General anesthesia, local anesthesia, or muscle relaxants to make bone manipulation and fixation of bone fragments possible.
• Narcotic or synthetic narcotic pain relievers for severe pain.
• Acetaminophen (available without prescription) for mild pain after initial treatment.

Home Diet

• Drink only water before manipulation or surgery to treat the fracture. Solid food in your stomach makes vomiting while under anesthesia more hazardous.
• During recovery, eat a well-balanced diet that includes extra protein, such as meat; fish, poultry, cheese, milk and eggs.

Diagnostic Measures

• Your own observation of symptom.
• Medical history and exam by a doctor.
• X-rays of the hand.

Prevention Tips

• Develop strength in your hands.
• Use appropriate taping, padding or protective equipment for the hand and thumb.