Thumb Injury After Impact: Why You Need Prompt Evaluation

A thumb injury from a direct blow or fall is not "normal" if it causes persistent pain, swelling, deformity, or limited motion. These signs suggest possible:

• Fracture: Bennett’s (base of 1st metacarpal), Rolando, extra-articular, or phalanx fractures.
• Ligament tear: Ulnar collateral ligament (UCL) – "Gamekeeper’s/Skier’s thumb."
• Dislocation: MCP or IP joint.
• Tendon rupture: Extensor pollicis longus (mallet thumb) or flexor.

Immediate Steps

1. Immobilize: Thumb spica splint (commercial or improvised with tongue depressor/tape).
2. Ice: 15–20 min every 1–2 hrs (barrier cloth).
3. Elevate: Above heart level.
4. NSAIDs: Ibuprofen/naproxen for pain/inflammation.
5. Urgent Evaluation: X-rays needed to rule out fracture/dislocation. UCL tears may need MRI/stress views.

Why Timing Matters

Delayed treatment of UCL tears or displaced fractures leads to chronic instability, arthritis, weakness, and possible need for reconstruction vs. simple repair.