Thumb Fracture: Signs, Diagnosis, and Urgent Care
A thumb fracture (often Bennett or Rolando fracture at base of 1st metacarpal, or phalangeal) presents with:
- Pain (severe, localized at base or along shaft).
- Swelling, bruising (ecchymosis).
- Deformity (angulation, rotation, shortening).
- Tenderness to palpation.
- Limited ROM (cannot oppose, grasp, pinch).
- Crepitus (grinding sensation).
Diagnosis
X-ray (AP, lateral, oblique) confirms fracture, displacement, intra-articular extension. CT for complex intra-articular patterns.
Management
- Non-displaced: Thumb spica cast/splint 4–6 weeks.
- Displaced/unstable/intra-articular: Closed reduction + percutaneous pinning (CRPP) or ORIF.
- Bennett/Rolando: Usually surgical (ORIF) to preserve carpometacarpal joint.
Seek immediate care for suspected fracture—delay risks malunion, arthritis, stiffness.
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