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  • Randon Hall, MD

Thumb Fracture Review

Updated: Aug 2, 2019

We are in the first week of training camp and already have three reports of thumb fracture on the injury wire. Ravens QB Robert Griffin III, Patriots WR Julian Edelman and Giants WR Sterling Shepard all have reported thumb fractures. Details are fairly light but thankfully all are considered to be non-surgical. With this trio of fractures, thought it was a good prompt to review some of the classic thumb fractures.


Normal Thumb


Here is a look at the typical thumb on x-ray. Notice, the sesamoid, a round structure off of the metacarpal head which is frequently confused for a fracture.


Oblique Proximal Phalanx Fracture

  • Injury: Jammed finger or direct trauma

  • Tx: Thumb Spica brace or Splint 4-6 weeks

  • RTP: Would consider play with protection or injury to non-dominant hand

  • Sx: Consider surgery if displaced or step-off greater at articular surface







1st Metatarsal Fracture

  • Injury: Direct impact to top of thumb

  • Tx: Thumb Spica brace or Splint 6-8 weeks

  • RTP: Would consider play with protection or injury to non-dominant hand, position dependent

  • Sx: Consider surgery if angulation greater than 30 degrees




Bennett Fracture

  • Injury: Significant trauma to directly thumb in flexed position

  • Tx: Typically surgery is needed. Note metatarsal is partially dislocated

  • RTP: Would not allow return to play until full healed. High risk for arthritis

  • Sx: If non-displaced can consider non-operative treatment, but very unstable.



Skier's Thumb

  • Injury: Thumb forced outward from the hand.

  • Tx: Minimally displaced treated with thumb spica cast

  • RTP: Would consider return with hard cast, position dependent.

  • Sx: Usually associated with ligament injury, if bony fragment acceptable usually same for ligament.





Tuft Fracture

  • Injury: Crush injury or Stepped on

  • Tx: Typically treated with simple finger splint

  • RTP: Return based on pain and function

  • Sx: Usually associated with significant soft tissue injury to nail bed, watch for infection.


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Copyright 2017 The Sports Source, LLC

Dr. Randon T. Hall

A sports medicine physician with a passion to educate. My mission is to provide clear, concise and up to date education to athletes and sports fans for a better understanding of sports related health issues.

 

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