Broken Thumb

A broken thumb refers to a fracture on the small bones also called phalanges. The two small bones compose the thumb. Breakage of the thumb is rare compared to broken finger. A fracture on the thumb bones is usually less serious compared to one that occurs near the joints. It is worse when the breakage occurs at the bottom of the thumb near the wrist. Thumb fractures are rare because the bones are thick and the thumb is shorter compared to other fingers hence is easily protected by the palm.

Risks and causes of a thumb fracture

A thumb fracture is caused by strong direct stress on the thumb such as a fall. It can occur when a ball in motion pulls back the thumb. Other fractures are caused indirectly through muscle contractions or twisting and are common during wrestling, football, hockey and skiing. Individuals with bone diseases and deficiency in calcium are at a high risk of thumb fractures.

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There are several practices that one can carry out to reduce the risk of suffering the fracture. Most importantly, ensure you use protective padding, tapping, and other equipment when engaging in activities that put you at risk. Strengthening hands through proper nutrition and regular exercise will help protect one from the risk.

Symptoms of a fractured thumb

Symptoms of a broken thumb include deformity, numb feeling, bruising and swelling, decreased motion, and pain when moving the thumb.


Doctor examination

One should consult a doctor immediately they have a thumb injury that they suspect could be a fracture. Delay to see a doctor can make it more difficult for the thumb to heal quickly. This is so as the thumb continues to swell making efforts to align the broken bones more complicated.

Padded splints are used to ensure the bones don’t move further out the initial alignment. This should be encouraged even before treatment can be finalized. The doctor will evaluate the intensity of the injury, determine the medical history of the patient, and may also order for an x-ray.


Treatment of broken thumb

There are various ways of treating a thumb breakage depending on the significance of the displacement. The major methods are discussed below.


Nonsurgical treatment

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If the dislocated bones have not moved much or the fracture has occurred on the shaft (middle) of the bone, surgeons are able to hold the displaced bones in place using spica cast, specifically designed for that purpose. The patient will have to wear the spica cast for about four to six weeks depending on the intensity of the injury. During that period, an x-ray may be necessary to ensure that the bone is still in alignment.


Surgical treatment

A surgery may be necessary depending on the displacement of the fragments from the bone. The surgeon will use one of operative fixation methods to bring the broken fragments back to alignment. The fragments are held in place throughout the healing process.

The operative fixation techniques include devices that ensure bone fragments remain in alignment inside or outside the body. Internal fixation methods include use of devices such as pins, wires, screws and plates. External fixation methods comprise use of pins in bones and which are held by attaching them to external fixation devices.

Splints or casts are worn for two to three weeks after the surgical treatment. After removing the cast or splint, hand therapy is encouraged to restore hand movement to normal. It takes around three months to completely recover and use the hand normally depending on the intensity of the thumb injury.


Broken Thumb – Healing Time

In most cases, the patient will leave the hospital or clinic with a splint and a dressing. They should not tamper with the splint as it is the main component that is holding their broken thumb in position. It is vital the dressing be kept clean to avoid infection.

The hand should be kept on rest and not engaged much until one visits the doctor for appointment, which is mostly one week after the initial treatment. During the appointment, the physician will ensure that the broken fragments are still in alignment and healing is taking place as expected. The thumb will take around 4 to 6 weeks to completely recover.

It is vital that the finger be exercised regularly after healing. If the thumb is kept dormant for long, eventually, the joint will become stiff making it hard to function as before. One can consult a physiotherapist for guidance on hand exercises that will help keep the thumb moving.

The prognosis and outcome of the thumb fracture is determined by the strength of energy that caused the break. Injuries caused by high energy lead to articular surface damage, comminution, and soft tissue injury. Such predisposes patients to degenerative stiffness and changes, hence a poor outcome. On the other hand, low energy injuries cause minor fractures and little soft tissue damage, and the prognosis is often excellent.

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