Healing A Broken Thumb: Hospital Treatment Options

Breaking your thumb can be a serious problem, as it can affect your ability to grasp items and may increase your risk of arthritis later in life. Treatment for a broken thumb depends on the severity and location of the break. Doctors will typically take X-rays to diagnose the fracture and recommend treatment. Treatment options may include a splint, cast, or surgery. Recovery times for a broken thumb vary based on the type of treatment, but a broken thumb usually heals within 6 to 8 weeks, and it may be 3 to 4 months before full strength returns to your hand.

Diagnosis: X-rays to determine the fracture

A broken thumb can be a serious problem. Loss of thumb function due to a fracture can affect your ability to grasp items, and certain types of thumb fractures can increase the risk of arthritis later in life. The bones of the thumb have several important ligaments at each joint that allow for motion and keep the joint stable. All of the bones in the thumb are susceptible to fracture, and the way a thumb breaks may determine the treatment.

If a person suspects that they may have broken their thumb, they should seek immediate medical treatment. A healthcare provider will use X-rays to diagnose finger and thumb fractures. X-rays will help determine the fracture and recommend treatment. Waiting to seek care can impact a doctor’s ability to correct the fracture at a later time.

X-rays will help doctors identify the type of fracture, including its exact location in the thumb. Thumb fractures can occur anywhere along its two bones: the distal phalanx (the bone under the nail that makes up the tip of the thumb) or the proximal phalanx (the next bone). The distal phalanx and proximal phalanx connect via the interphalangeal (IP) joint, which allows you to bend the tip of your thumb. The thumb connects to the hand through the metacarpophalangeal (MCP) joint. This joint sits between the proximal phalanx and a bone in the hand called the first metacarpal. Fractures of the thumb metacarpal can also occur in the long portion of the bone, called the metacarpal shaft.

X-rays will also help doctors determine the severity and location of the break, which will inform the need for surgery. A break in the base of the thumb often requires surgery because it can be difficult for a doctor to apply a splint or cast to the thumb. A Bennett fracture, for example, is a fracture at the base of the thumb metacarpal involving the CMC joint, resulting in a clean break with a sizeable piece of bone broken off. A Rolando fracture is similar, except that instead of a clean break, the bone is shattered into several pieces.

Splints and casts: Immobilisation to aid healing

Splints and casts are often used to immobilise a broken thumb, aiding in the healing process. Immobilisation is a common treatment for broken thumbs, which can be stabilised with a splint or a cast, sometimes in combination with surgery.

Splints are often used for mild to moderate thumb injuries, including sprains and minor fractures. They can be used to stabilise the thumb and restrict movement, allowing the injury to heal. Thumb spica splints are often used for this purpose, and can be purchased over the counter at a drug store or online. In some cases, a splint may be worn for just a few weeks, and gentle exercises can be performed to prevent stiffness and promote healing.

Casts are another method of stabilising and immobilising a broken thumb. They are often used in conjunction with surgery, to hold the bones in place while they heal. Casts are usually worn for 4-6 weeks, and physical therapy is often recommended after they are removed to restore movement and strength to the thumb.

In some cases, a doctor may be able to correct a broken thumb by manipulating the thumb back into place and applying a cast. This method does not require surgery.

Both splints and casts can be effective methods of treating a broken thumb, and the chosen method will depend on the location and severity of the break.

Surgery: For severe breaks, realignment and fixation

Surgery is often required for severe thumb breaks. The decision to perform surgery depends on the location of the break, the alignment of the broken bone, and the amount of movement between the fragments.

Surgical techniques involve the placement of hardware or devices, either internally or externally, to secure the fragmented bone pieces. Internal fixation techniques use wires, pins, plates, and screws to align the bones properly and hold them together. External fixation techniques use a device that attaches to the outside of the thumb area. Pins are attached to the fragments from outside the body, stabilized by the device.

After surgery, a cast or splint is typically worn for 2 to 6 weeks. Following this, physical therapy may be required to restore full thumb mobility. In some cases, even after surgery, the fractured thumb bones may not heal correctly or may become misaligned, leading to persistent pain and diminished strength and function.

It is important to treat a thumb fracture as soon as possible, or the bones may not heal in proper alignment. Thumb fractures generally heal well if the bones remain in a stable position with good alignment. However, surgery does carry some potential risks and complications, such as infection, wound issues, or failure to maintain alignment.

Pain management: Ice packs, elevation, and medication

If you suspect that you have a broken thumb, it is important to seek immediate medical attention. In the meantime, there are several things you can do to manage the pain and reduce swelling:

Ice packs

Apply a cloth-covered ice pack to the thumb for 15 to 20 minutes every 2 to 3 hours. This will help to reduce pain and swelling. An ice massage can also be used to target the area of discomfort. Use an ice cube and hold it with a washcloth, making small circular motions for three to five minutes multiple times a day.

Elevation

Keep your hand elevated above your heart when resting, by supporting it with pillows. This will help to reduce swelling and discomfort.

Medication

Take paracetamol to help ease the pain. Anti-inflammatory medication, like ibuprofen or naproxen, should be avoided as they have been shown to delay healing. When you see the doctor, they may suggest different or stronger painkillers if needed.

Recovery: Physical therapy, exercises, and rest

Recovery from a broken thumb can take some time, and physical therapy, exercises, and rest are all important parts of the healing process. Typically, a broken thumb will heal within 6 to 8 weeks, but it can take up to 3 to 4 months for full strength to return to the hand. It is important to follow the advice of your doctor or healthcare provider, as they will be able to recommend specific treatments and exercises to aid your recovery.

Physical therapy is often recommended following a thumb fracture, especially after a cast has been removed. This usually involves strengthening and stretching exercises to help regain movement and strength in the thumb and hand. These exercises can include gentle hand exercises, such as moving the thumb, fingers, and wrist to increase movement and flexibility. Stretching exercises are important to prevent stiffness in the thumb, especially after immobilization. Your doctor or physical therapist will be able to advise you on when to begin these exercises and how often to do them.

Rest is crucial in the initial stages of recovery. For mild to moderate thumb fractures, rest and immobilization of the thumb are usually recommended for at least 48 hours after the injury. Keeping the hand elevated can also help reduce swelling, and it is recommended to rest the hand on a cushion or pillow. It is important to avoid activities that cause pain or discomfort, and to stop exercising if symptoms worsen or cause new pain.

In addition to physical therapy and rest, there are some other general considerations to aid recovery. It is beneficial to use your hand in day-to-day activities, such as eating, dressing, or typing, as long as pain allows. However, it is important to avoid contact sports or heavy lifting until at least 12 weeks after the fracture. Smoking can also affect recovery, slowing down healing times, so it is advisable to stop smoking during this period. Maintaining a healthy diet and staying active can also promote healing.

Frequently asked questions