One of the most difficult to bear and quite dangerous is a fracture of the thumb. Despite the fact that it is the only finger that is located separately in its anatomical location, its role in the functioning of the hand is very large. The activity of the hand largely depends on the capabilities of just this finger. It accounts for almost half of all functions of the hand.
Types of fractures
Fracture of the thumb can be conditionally divided into two types:
- traumatic;
- appearing under the influence of other influences or diseases.
It should be noted that their symptoms are very different. Most often, the first type is characterized by concentrated and sharp destruction of bone tissue. Otherwise, a fracture may be the result of long-term destruction, as well as cracks formed earlier.
All bone fractures by typedamage can be divided into the following types:
- Helical - on x-ray as a result of a fracture of the thumb, you can see the formed acute angle. The resulting fragments in this case will be directed in different directions from the bone.
- Oblique – An x-ray can show a clear image that shows the presence of a sharp bone lobe, as well as a cut that is at an acute angle.
- Comminuted - this injury is characterized by the presence of at least three pieces of bone tissue at the base of the fracture. In the picture, a gap remains visible between the chips. Such voids can be either vertical or horizontal.
- Longitudinal fracture of the thumb is a fairly rare injury, in which the finger bone is separated into two parts along the proximal and distal phalanges.
- Transverse - as in the previous version, the bone is divided into two parts. Only in this case, the fracture occurs across, and not along the base of the entire bone tissue.
Traumatic fractures are classified separately. A thumb injury can be:
- Open. This is a fairly severe form of injury. In this case, along the fracture line, all bone fragments are visible through the skin cover. The severity of this ailment is due to the fact that the risk of infection of both flesh and bone tissue with infection increases. For the distal and proximal phalanx, the risk of developing acute osteomyelitis increases.
- Closed. It is considered a more successful type of fracture, in which there is no damage to soft tissues. Fragments are placed exclusively at the site of injury.
Depending on how the thumb is broken, a decision is made whether to perform surgery or conventional treatment that does not involve surgery.
Causes of fracture
Quite often the causes of this problem are various games with a hard ball or falling on a limb. During a fracture, you can get a dislocation and bruise of the finger on the hand, which will further aggravate the situation. You can get this type of injury due to the fall of a weighty object on the hand or getting it into the driving mechanisms.
Localization of injury in this case can be very different. Fractures are located inside the joint or can be divisive, just they always accompany an unsuccessful outcome.
Risk groups
Fracture of the thumb occurs quite often in the following categories of citizens:
- Children.
- Professional athletes who are most often involved in basketball, boxing or volleyball.
- Osteoporosis patients.
- Elderly.
- People working with dangerous machines.
- Menopausal women.
Symptoms of a broken thumb
- Immediately after acquiring an injury, a person feels pain and severe burning in the thumb area.
- On examination, it can be observed that the area of injury will be greatly enlarged due to the formation of edema.
- Bat the time of examination by a doctor, he will definitely see reddening of the epidermis at the fracture site.
- In some victims, due to the fact that the finger is swollen and the bone shifts slightly, the phalanx deviates to the other side.
- The finger may be very pale with an area of hematoma.
- Hemorrhage often forms under the victim's nail, which will later lead to detachment of the nail plate.
- A person who has been injured partially or completely loses the ability to actively move. However, in some patients, on the contrary, pathological mobility of the thumb on the hand can be observed.
- Quite often, a fracture of the phalanx of the thumb is accompanied by a change in the integrity of the nail layer.
- At the moment of palpation, you can hear the crepitation of debris (a characteristic crunchy sound that occurs when they rub against each other).
- After an injury, the axis of the thumb will be broken without fail.
- One of the symptoms of such a problem is the activation of pain when the doctor gently taps the top of the finger towards its base. It must be remembered: if there is a fracture of the thumb with a displacement, then such a procedure is strictly prohibited, as it can aggravate the situation.
- Sometimes doctors without x-rays can palpate a bone defect in the area of injury.
- On examination, you can see that the injured finger has become a little shorter in relation to the he althy one.
- At the moment of impact with heavy objects on the finger, a visually pronouncedbone deformity.
- Due to the fact that the thumb on the hand at the base is very sore, the function of the hand will necessarily be impaired in the victim.
- Palpation of the injured area is very painful for the patient.
- In the presence of open fractures in a patient, parts of a broken bone can be visualized from the wound surface and there may be active bleeding due to vascular damage.
Diagnosis
In order to understand how to determine the fracture of the thumb, you definitely need to be a doctor. It should be noted that the diagnosis of this problem is not always easy. But very often, literally by sight without using a picture, you can diagnose the presence of an ailment. X-rays are most often needed only to confirm certain symptoms.
Diagnosis becomes more complicated only when medical care was provided incorrectly or not at all. And also in the case when the finger is swollen, palpation becomes problematic.
First Aid
If possible, you should immediately go to the emergency room. In the absence of this, it is imperative to call an ambulance.
There are times when help must be provided immediately before the ambulance arrives. In this case, you need to know certain rules.
The joint of the thumb on the hand always hurts because of a fracture, but due to the release of adrenaline into the body, the victim does not feel it. However, after 2-3 minutesthe action of the substance stops. At the site of a fracture or bruise, very strong sensations arise that a person can hardly endure.
After determining the focus, it is required to “freeze” the place. For this, a cold object is used, which is an analogue of anesthesia. It will not be possible to completely eliminate all discomfort, but it will be possible to lower the post-shock situation.
If there are painkillers at home, then you need to give them to the victim in the amount indicated in the instructions.
Regardless of whether the finger is broken or bruised, it is imperative to fix the limb. A special material is used to apply the tire. Most often, it is not at hand, so it will be sufficient to fix the thumb to the adjacent one. When fixing, one should not forget that in the future the phalanx will increase in size, because it will swell, and an overly tight bandage will close the flow of blood to the limb. Therefore, you need to fix it very carefully with the calculation of the margin.
Conservative treatment
Treatment of a fracture of the base of the thumb with a displacement, any doctor should begin only with a comparison of all the fragments.
Initially, local anesthesia is performed using Lidocoin or Novocaine, and then the doctor repositions. The doctor's assistant does stretching along the entire length of one hand by the thumb, and with the other hand stretches 2-5 fingers. The surgeon needs to lay a bandage in the first interdigital lumen, and then, by pulling on the bandage, he performscountertraction. Such a manipulation is done for 5–7 minutes.
Further actions of the doctor are aimed at the fact that he sets the thumb in the position of maximum abduction, and then puts a cast on the thumb and a circulating bandage that fixes the entire thumb and is fixed on the upper third of the forearm.
The patient, who has already had a cast, is given a second X-ray examination to confirm that everything was done correctly.
For a non-displaced fracture, conservative therapy is to apply a Baler splint (also very often used palmar plaster tape). Many patients are interested in how long a thumb fracture heals. With such an injury, the victim with a cast needs to walk for 2-3 weeks, and after, for a month, everything is finally restored.
When a victim has a tendon injury in addition to a fracture, it is initially necessary to achieve bone fusion, and then the doctor deals with tendon plastic surgery.
Surgical treatment
The operation for such an ailment is performed using screws and knitting needles. It may include two or one stage:
- With one-stage osteosynthesis, bone fragments are fixed to the patient with various devices that remain on the bone all his life. The regeneration process takes about a month and a half.
- With two-stage osteosynthesis, all fasteners are removed 3-4 weeks after the operation. Recovery in this case will take two months.
To the personafter the plaster is removed, rehabilitation measures are mandatory, which include massage, physiotherapy and therapeutic exercises.
When the patient's thumb hurts at the base, he is shown thermal procedures, which include baths with s alt and dry heat.
Using the finger retainer
The procedure for matching the fragments is done by the doctor, who initially anesthetized the fracture site. Regardless of the severity and type of fracture, an important step in therapy is the immobilization of the damaged area in special ways:
- Plaster cast - it is located from the top of the forearm to the end of the injured finger, which must be partially open to trace the presence of normal blood circulation.
- A good alternative to plaster is a fiberglass rigid splint, which is used most often in difficult cases. A similar retainer is placed from the wrist to the end of the phalanx and firmly fixes it.
- Increasingly, recently, a special orthopedic fixator - an orthosis - has begun to enjoy special popularity. This is an innovative device used to immobilize a damaged phalanx. It is attached at the level of the distal and middle phalanges, forming a secure fixation. For a thumb with an injury, an orthosis is made in a special shape. For it, certain materials are used, which, unlike a plaster cast, are quite comfortable. The retainer is easy to remove, but requiresknow that such manipulation is performed exclusively under the supervision of a doctor. Otherwise, the regeneration process may take a long time.
How long does the cast last?
Closed fractures with proper care are not particularly dangerous, so the period of wearing such a bandage is 2-3 weeks. Full regeneration occurs after 3-4 weeks.
Medium fractures will take 6-8 weeks. The first four weeks are focused on plaster immobilization.
Recovery after complex fractures reaches ten weeks. Wearing a cast using needles and screws takes up to six weeks. If complications occur during rehabilitation, this period may increase.
Rehab
The recovery process is always one of the most difficult steps. After applying the cast, the muscles begin to suffer greatly. Atrophied tissues need further renewal. Often with a partial or complete decrease in the function of the brush is assigned:
- physiotherapy;
- massage;
- gymnastics.
All of the above procedures are done 3-4 times a day. Particular and most important attention should be paid to physiotherapy, as it most quickly restores the lost functions of muscles and tendons, after which a person can lead a normal life.
Purpose of physiotherapy
If the joint of the thumb on the hand hurts after a fracture, such procedures are very necessary. They are directed to:
- to relaxvascular smooth muscle;
- pain reduction;
- softening ligaments;
- increase blood circulation in tissues;
- removal of edema;
- reduction of inflammation processes in soft tissues;
- prevention of ankylosis.
Residual effects
From some patients, you can hear that after a fracture, their finger hurts or does not bend. As anesthesia, patients are recommended to use non-narcotic analgesics in tablets (Paracetamol, Analgin, Pentalgin). When the ligaments are not developed in the patient, then his finger will hardly bend. If all the bones of the thumb grow together correctly, then paraffin applications, massage and physiotherapy exercises are prescribed for it, and ointments such as Piroxicam or Chondroxide must be rubbed into the finger.
Prevention
Often, a fracture of the thumb leads to dysfunction of the hand, so it knocks a person out of his usual way of life for a long time. Therapy takes a lot of time, so it is best to try to avoid such injuries by using simple preventive measures:
- Balanced and proper nutrition is the key to the he alth of the whole organism. The more vitamin D and calcium a person consumes, the less their bones are prone to fracture. It is required to include cottage cheese and sour-milk products in your diet, it is useful to use broccoli, legumes, nuts, white cabbage and sesame seeds. In addition to the presence of calcium, magnesium is present in these products, which strengthens and restores bonefabric.
- Bad habits negatively affect the entire body. Nicotine prevents the assimilation of many trace elements, and alcohol provokes traumatic situations that lead to fractures and bruises. Therefore, maintaining a he althy lifestyle is especially important for human life.
- Many injuries are due to human negligence. Therefore, do not neglect safety in the workplace. It is necessary to use automatic tools and appliances carefully.
- Constant exercise helps to strengthen the hands. It is required to remember that any lesson should begin only with a warm-up. Before giving loads to the hands, the joints and phalanges of the fingers need to be well warmed up, otherwise the presence of injury cannot be avoided. To do this, you can apply simple exercises:
- rotate brushes in a circle;
- same spins, but hands must be locked;
- dynamic clenching into a fist of the palms.
