Broken Thumb: Causes, Risk Factors, Symptoms, Treatment, Exercises, Investigations
What is a Broken Thumb?
The thumb consists of two small bones called distal phalanges and proximal phalanges. The distal phalange extends from the thumb tip to the knuckle. Proximal phalange extends from the knuckle to the thumb base. This is the region of webbing involving the first finger and the thumb. The thumb is attached with the first metacarpal bone in the hand. A broken thumb is a condition in which fracture occurs to any of the two phalanges which build up the thumb. A thumb fracture is less common when compared to a finger fracture.
A break may occur to either of the thumb bones, but the break near the joints is really serious in nature especially when the break or a fracture is caused at the base of the thumb close to the wrist.
The reason for the fewer occurrences of the thumb fractures may include the thickness of the bones or the thumb being opposable and shorter than the other fingers and therefore frequently gets protected by the palm.
In case of simple fracture to the phalanges of the thumb, it generally heals up simple treatment but when if there is a fracture at the ends of either bones close to the joints then it becomes a little bit difficult to treat. Bennett fracture and Rolando fracture are classic examples of complicated thumb fractures, which occur at the joint between the wrist and the first metacarpal.
Broken thumb or fractured thumb is quite common in contact sports like hockey, basketball, soccer, etc.; however, thumb fracture may also result from falls while doing activities like snowboarding, skiing, etc.
While playing, appropriate protective gear should be used in order to reduce the chances of a thumb fracture to occur like gloves etc.
- Direct trauma is the major reason for the broken thumb, which may involve falling on the thumb or a trauma to the thumb.
- Broken thumb or thumb fracture may also be caused with contact sports like wrestling, soccer, etc.
- Broken thumb or fractured thumb may be caused because of bone disease like osteoporosis and calcium deficiencies which are more likely to increase this kind of risk.
- A thumb fracture may also occur when there is a backward force to the thumb applied by an object like a ball while catching it.
- A thumb loses its ability of gripping an object.
- A broken thumb may also lead to the risk of arthritis in future.
- Sudden onset of pain is a common symptoms of broken thumb or fractured thumb.
- Feeling of a click with motion of the thumb.
- Gripping or lifting is painful in case you are dealing with broken thumb or fractured thumb.
- Painful motion of the thumb.
- Bruising or swelling may also be present if you have encountered a broken thumb or fractured thumb.
- Presence of tenderness in the affected area of the thumb.
- Malalignment of nails of the finger.
- Excruciating pain around the thumb is felt.
- Thumb has a numb feeling to it.
- Decreased motion of the thumb joint.
- Deformity of the thumb.
Treatment of Broken Thumb
- Generally, conservative route suffices for treating broken thumb or thumb fracture where there is no significant displacement or rotational deformity. Conservative care for broken thumb or fractured thumb involves closed reduction under local anesthesia followed by casting or splinting of the hand and the thumb. Broken thumb or Fracture thumb may require about six to ten weeks for complete recovery, which involves a period of immobilization for about four to six weeks followed by protective splinting for about six weeks. Regular x-rays may be needed for continuous monitoring to ensure that the bone has maintained its proper position and alignment.
- Thumb spica cast or splint is a specially designed cast or splint for treatment of broken thumb or fracture thumb.
- Surgery for broken thumb may be recommended in severe cases where there are multiple fractures or open wound. Two factors play a major role in determining if surgery is warranted for broken thumb or fractured thumb.
- Length: If the digit (thumb) gets shortened or decreases in length due to fracture, surgery is recommended to restore the digit (thumb) to its normal size.
- Rotation: In cases where the digit (thumb) gets abnormally rotated due to the fracture, surgery is recommended to correct the deformity and restore the digit (thumb) to its normal position.
- Metal implants such as plates, wires, and screws are used to fix the broken fragments of bone depending upon the nature and type of the thumb fracture.
- Surgery for broken thumb or fractured involves risks of infection, bleeding, neurovascular injury, as well as hardware failure.
Exercises for Broken Thumb
Stretching and strengthening exercises is required to be performed in the recovery period for attainment of full motion of the thumb following thumb fracture.
Stretching Exercises for Broken Thumb
- Flexion Exercise For Broken Thumb in Post Recovery Phase: The exercise is done by having the wrist bent in a forward direction until there is a feeling of a pain-free stretch. This position needs to be held for at least 5 seconds and should be performed in 2 sets of 15.
- Extension Exercise For Broken Thumb in Post Recovery Phase: This exercise can be done by having the wrist bent in a backward position until there is a feeling of a pain-free stretch. This position needs to be held for at least 5 seconds and should be performed in 2 sets of 15.
- Side to Side Exercise For Broken Thumb in Post Recovery Phase: This exercise is done by movement of the wrist from one side to the other until there is a feeling of a pain-free stretch. This position needs to be held for at least 5 seconds in each direction and should be performed in 2 sets of 15.
Strengthening Exercises for Broken Thumb
- Opposition Stretch: This exercise can be done by keeping the hand on some form of table with the palm facing upwards. Then, the tip of the thumb should be joined with the tip of the small finger and this position should be held for at least 5 seconds and repeated at least 10 times.
- Wrist Flexion: For this, a soup handle can used to hold it in the hand with the palm facing towards the roof. Then the wrist should be bent upwards with slowly decreasing the weight and coming back to the starting position. It should be performed in 2 sets of 15 and the weight should be gradually increased.
- Wrist Extension: For this, a soup handle can used to hold it in the hand with the palm facing downwards. Then the wrist should be bent upwards with slowly decreasing the weight and coming back to the starting position. It should be performed in 2 sets of 15 and the weight should be gradually increased.
- Grip Strengthening: This exercise is done by holding a soft textured ball in the hand and squeezing as much as it can be squeezed without aggravating the pain. This position should be held for at least 5 seconds and then released. This should be repeated at least 10 times making sure that there is no aggravation of symptoms.
- Finger Spring: This exercise is done by use of rubber band by wearing it in the fingers and stretching it using fingers. It should be performed in 2 sets of 15.
What To Do For Broken Thumb?
If you have injured your thumb causing instant and severe pain, it is advisable that you don't try manipulating your thumb. You need to visit a doctor to get your thumb evaluated to see if it has been fractured or not. comprehensive history and physical examination is required for diagnosis of broken thumb. A thorough neurovascular examination of the hand is done to look for injuries to nerves and vessels. The first step in diagnosis is an x-ray which goes a long way in looking for position of broken bones in the thumb.
Other Studies Include