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Thumb Fracture

Thumb Fracture is a topic covered in the 5-Minute Emergency Consult.

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  • Distal phalangeal fractures:
    • Blunt trauma, hyperextension of the thumb, axial loading of the thumb, and crush injuries.
    • Tuft fracture is a similar fracture in other digits, in which the distal phalanx is crushed and/or fragmented.
    • It may be open or closed and associated with nail bed injury.
    • Severe nail bed injury, intra-articular, displaced/angulated fractures, or tendon injuries warrant orthopedics’ consultation.
    • Noncomplex tuft fractures can be splinted and treated as soft tissue injuries.
  • Proximal phalangeal fractures and thumb metacarpal fractures:
    • Blunt trauma to the thumb:
      • Axial loading of the thumb with the metacarpophalangeal (MP) joint partially flexed, the hand closed or the thumb MP joint otherwise stabilized
    • Bennett fracture (type I):
      • Intra-articular fracture/dislocation at the base of the metacarpal where the ulnar aspect of the metacarpal maintains its attachment.
    • Rolando fracture (type II):
      • Comminuted Y- or T-shaped intra-articular fracture of the base of the 1st metacarpal.
      • Similar to a comminuted Bennett, these can be much more complex with multiple comminuted fractures.
    • Type III fractures
      • Extra-articular metacarpal fractures. Tend to be transverse or less commonly oblique.


  • Falls, hyperflexion, hyperextension
  • Motor vehicle accidents
  • Sports, especially downhill or alpine skiing
  • Basketball
  • Baseball
  • Football
  • Rugby

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Rosen, Peter, et al., editors. "Thumb Fracture." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307512/all/Thumb_Fracture.
Thumb Fracture. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307512/all/Thumb_Fracture. Accessed April 25, 2019.
Thumb Fracture. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307512/all/Thumb_Fracture
Thumb Fracture [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 25]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307512/all/Thumb_Fracture.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Thumb Fracture ID - 307512 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307512/all/Thumb_Fracture PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -