Although a fracture can occur in any bone of the thumb the most serious is near the joints. This is true particularly when it occurs at the base of the thumb near the wrist. There are different types of thumb fractures. Bennett and Rolando fractures occur at the base of the thumb. They involve the joint between the thumb metacarpal and a specific wrist bone. Fractures that are more difficult to treat and are at an increased risk of an unfavourable outcome often involve the joints. Thumb Fractures can be caused by direct impact such as a fall or when a ball catches and pulls the thumb back. Sometimes a fracture can be caused indirectly, from twisting or muscle contractions as happens occasionally in sports such as football, hockey or skiing.
Thumb fractures can often be severely painful, swollen and extremely tender. The ability to move the thumb can be limited or sometimes impossible. Numbness and coldness can also be a symptom.
Non-surgical: if the fracture isn’t displaced or located in the middle shaft of the bone a specially designed cast may be used to hold the fragments in place. This may need to be worn for at least four to six weeks. X rays may be required to monitor the alignment of the fracture.
Surgical: Depending on the location of the fracture and the movement of the bone fragments surgery may be needed. Fixation of the fragments is used to realign the bones and hold them in place while the fracture heals. Internal fixation of the bone requires the use of wire, pins, plate and screws. For two to six weeks post surgery a cast or splint will be required as well as hand therapy to help restore movement in the thumb.
It generally takes six weeks for the bone to heal and unite following a fracture, with therapy exercises prescribed following this to regain strength and movement.