Causes and risk factors
Unlike any other fracture, the major cause of thumb fractures is road accidents or vehicle injury. Fall on wrist with thumb flexed and which causes severe pressure or force on the bone can lead to its breakage. Indirect trauma can also lead to fracture. It can also be associated with muscular or ligamentous injuries of the wrist. Microtrauma resulting due to repeated force or trauma is another contributing factor seen. This is particularly seen in various sports activities like hockey, football, or wrestling. People with weak bones and weak strength of muscles and those suffering from bone diseases and having calcium deficiency are more prone to fractures.
Clinical presentation:
The fracture can either take place at the base of the thumb or at the shaft of the metacarpal. Depending upon the location of the fracture, thumb fracture is divided into various types – Type I, type II, type III and type IV. Type I and II are intra-articular fractures while III and IV are extra-articular type. Pain is a prominent feature seen. Along with this, swelling and bruising are other complaints. Weak grip is complained by the patient. Difficulty in movement of the thumb is seen; movement aggravates pain. In cases of severe injury to the bone, deformity of the thumb can be seen. On examination, tenderness is present.
Investigations:
Considering the symptoms, a local examination is carried out by the orthopedic doctor. There is often a history of injury. Usually an x-ray of the palm is sufficient for diagnosis. In severe cases, if required, MRI scan can be done.
Treatment:
Rest and application of ice pack are the essential steps to be implemented. Analgesic or nonsteroidal anti-inflammatory drugs are advised by the orthopedic doctor for relief of the pain. Spica cast is applied for immobilization for 4-6 weeks. In severe cases, surgical intervention is needed. It comprises of internal or external fixation of the bone with the help of screws, plates, or wires. As recovery starts, certain physiotherapy exercises are advised under the guidelines of a trained physiotherapist.
Other Modes of treatment:
Certain other modes of treatment can also be helpful in coping up with the symptom. Taking into consideration the symptoms in a holistic way, homoeopathy can offer a good aid for the relief of the symptoms. The Ayurvedic system of medicine which uses herbs and synthetic derivates can also be beneficial in combating the complaints. Certain yoga exercises can also be helpful in strengthening the muscles.
