Thumb Fracture
Basics
Description
Description
- 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
- Larger subungal hematomas should be decompressed or drained
- Thumb proximal phalangeal 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
- Blunt trauma to the thumb:
- Thumb metacarpal fractures:
- 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 first metacarpal
- Similar to a comminuted Bennett, these can be much more complex with multiple comminuted fractures. Usually greater force
- Type III fractures:
- Extra-articular metacarpal fractures. Tend to be transverse(IIIa) or less commonly oblique(IIIb)
- Type IV: Epiphyseal injuries seen in children
- Bennett fracture (type I):
Etiology
Etiology
- Falls, hyperflexion, hyperextension
- Motor vehicle accidents
- Sports, especially downhill or alpine skiing
- Basketball
- Baseball
- Football
- Rugby
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Citation
Schaider, Jeffrey J., et al., editors. "Thumb Fracture." 5-Minute Emergency Consult, 6th ed., Lippincott Williams & Wilkins, 2020. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307512/all/Thumb_Fracture.
Thumb Fracture. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307512/all/Thumb_Fracture. Accessed October 12, 2024.
Thumb Fracture. (2020). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (6th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307512/all/Thumb_Fracture
Thumb Fracture [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. [cited 2024 October 12]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307512/all/Thumb_Fracture.
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