You have a fracture of a thumb, and you have questions about how serious the fracture is, and if pain can go away on its own without treatment.
In this article I will take you through the frequently asked question you have about a thumb fracture. I do see many patients who come in for a thumb x-ray after weeks of their injury because they thought the future was not serious.
Based on my experience as a diagnostic radiographer and through exploration of scientific literature, I have put together this article for you.
Feel free to ask a question, sharing your experiences! Happy reading!😀
Last updated: March 2024. Written by Juliet Semakula, diagnostic radiographer.
Disclaimer: no affiliate links.
Thumb fractures are very common, disruptive injuries in both adults and children. These fractures come in all shapes and sizes, with some injuries more serious than others.
Although a broken thumb is sometimes not viewed as a major injury, nevertheless it can be a painful experience that limits your ability to carry out daily chores and everyday tasks.
Before delving into the treatment and rehabilitation tips of a thumb fracture, let’s briefly review some anatomy. (Truly just a tiny bit, I promise.)💁
We have three bones within the thumb, so a fracture can occur in any part:
1️⃣ First bone is called the distal phalange.
2️⃣ The second bone is called the proximal phalange.
3️⃣Metacarpal bone of the thumb marked in red.
Image shows the thumb with only two phalanges while other fingers have three:
Image source: Wikipedia.
The thumb can fracture in all the three areas but the most common I see in x-ray is the fracture on the metacarpal shaft near the joint. The anatomy is already complete!
These occur at the base of the thumb involving the joint between the metacarpal and the wrist bone can be more complex to treat.
It should be noted that also the tendons and ligaments around the thumb may rupture due to your injury which is usually classified as the MCP joint flexes, and the interphalangeal joint hyperextends.
Here treatment is usually a splint or fusion of selected joints. But if the instability is obvious, surgery repair is suggested followed by plaster immobilisation.
▶️Signs of a broken thumb and diagnosis
If you have broken a thumb, your injury will be referred to as a fracture, a break or crack.
Most common causes of a broken thumb are sports such as:
🏑Hockey.
⚽Football.
🏀Baseball.
Through falling onto an outstretched hand or simply catching a ball.
What to expect after a thumb fracture
🟪It will be painful.
🟪It will be swollen and bruised.
🟪 The thumb will be stiff and difficult to move.
🟪It may also change colour or feel numb.
At this stage it will be hard to tell if a thumb is broken. x-rays will be the first line of investigation to determine any dislocation or sprain.
Or CT scans may be performed as part of the definitive management work up to help see soft tissue damages because the x-rays do not project ligaments damage. Then the doctor will be able to give you a diagnosis before treatment.
▶️Broken thumb treatment options.
Once you have established that your thumb is fractured after x-ray, treatment will depend on:
🟪 The type and location of the fracture.
🟪Any associated injuries such as nerves, ligaments, and tendons.
🟪And your overall health and age.
It is important to establish whether you sustained just a sprain or broke as soon as possible because delayed treatment could result in a poor outcome to realign the bones properly which can slow down your recovery.
For a simple second proximal phalanx thumb fracture projected in the image below This is a non-surgical treatment. The doctor will follow these steps to treat your injury.
When you present it bent, the doctor will try to straighten your thumb and he will put a splint or a cast as in the image.
A cast is designed to hold the fragments of bone in place as it heals. This option is only viable if the fracture is not displaced or if the break has occurred in the middle part of the bone.
The cast is usually in place for at least 4 to 6 weeks. Further projection after these weeks will be requested to ensure your bone is healing well.
▶️Broken thumb surgery options
Surgery will come in if your fracture is completely comminated like in the Rolando and Bennett image views.
Surgery will help to realign the bone fragments and the best surgeon will determine the best option for your injury.
Do not forget that the end goal is to help speed your recovery by helping to hold the broken bones in place using the internal or external fixations. I will not go into the details of the whole surgery because I am not a doctor!
Images of a thumb surgery
Following your broken thumb surgery, a cast or splint must be worn over the broken thumb for between 2 to 6 weeks.
▶️Rehabilitation and therapy to help restore movement and fully recover.
The thumb requires further rehabilitation in the form of therapy to help restore movement and regain full use of the hand.
According to the physiotherapist I speak to, they advise that it can take 3 months or more, depending on the severity of the fracture, to completely use your thumb like before.
We should not forget that full recovery will depend on an individual.
Rehabilitation plan
| 0 to 3 weeks after treatment. | Use the affected hand within the split for light activities like dressing if pain allows! Gentle exercises with your thumb, fingers and wrist are advisable. Wean yourself-using a split as far as comfort allows |
| 3 to 6 weeks after your treatment | Your thumb can gradually return to full function. You can also resume normal day activities. Avoid contact sports or heavy lifting until at least 12 weeks post fracture. |
| 6 to 12 weeks the injury has healed and at this point you can do your normal activities. If you still experience significant pain consult your doctor. | |
▶️What to expect during the recovery period
Most of your thumb healing happens between 3 to 6 weeks, it’s normal to have aches, sensitivity, and discomfort during the healing process especially when you are trying activities you have not tried for a while.
Pain can change from day to day even when your fracture has healed some people have reported experiencing pain during the colder weather too.
🤝The GOOD NEWS is using your hand with day-to-day activities is good exercise, remember to rest it if you feel the discomfort.
Always consult your doctor or seek help if you cannot manage pain to avoid mental frustration during your recovery period.
Simple exercises of the thumb recommended by physical therapy
Examples of exercises for active mobilisation of the thumb after surgery from a fracture. Such good ranges of motions can help with your joint mobility. A therapist will work with you to develop a treatment plan.
This information is for guidance and education purposes, always use it as it fits.
▶️Why does my broken thumb still hurt after years of post-injury?
Pain after 6 months of treatment can be a bone healing problem. Get it checked by your doctor immediately.
Also, arthritis is one of the common complications of a broken thumb. The condition can be painful even after recovery. Arthritis does develop in the joints, and this can be an ongoing problem even after years of post-receiving the injury.
According to scientific studies arthritis can be treated if severe enough by elimination of the trapezium bone (Duckworth & Blundell 2010)
‘However, in a study of thumb fractures, people who received non-surgical treatment displayed a high incidence of degeneration of their thumb joints, and ongoing motion problems 26 years after receiving the injury to a thumb. Therefore, there was a greater uptake of surgical treatment for this type of thumb injury. Yet there is no data relating to the long-term outcome for those who underwent surgery for a Bennett fracture.’ (Livesley.,1990)
In conclusion the treatment of the thumb is often done through immobilisation, surgery if necessary and a consolidated recovery plan is put in place for your healing.
I hope I have answered some of the questions you have on thumb fractures.
I wish you a quick recovery !🙋
To support this article, I have identified scientific publications on the diagnosis, treatment, and healing time of a thumb fracture:
Number of studies per year published on thumb fractures and international journals.
Here are some of the articles I have relied upon for this article ,in addition to my professional experience.
📚Source:
Malisorn S. The Current Concept and Evidence-Based Practice in the Base of the First Metacarpal Bone Fracture. Cureus. 2024 Jan 3;16(1):e51600. doi: 10.7759/cureus.51600. PMID: 38173948; PMCID: PMC10764075.
Thurston AJ, Dempsey SM. Bennett’s fracture: a medium to long-term review. Aust N Z J Surg. 1993 Feb;63(2):120-3. doi: 10.1111/j.1445-2197.1993.tb00058.x. PMID: 8297298.
Timmenga EJ, Blokhuis TJ, Maas M, Raaijmakers EL. Long-term evaluation of Bennett’s fracture. A comparison between open and closed reduction. J Hand Surg Br. 1994 Jun;19(3):373-7. doi: 10.1016/0266-7681(94)90093-0. PMID: 8077832.
Kjaer-Petersen K, Langhoff O, Andersen K. Bennett’s fracture. J Hand Surg Br. 1990 Feb;15(1):58-61. doi: 10.1016/0266-7681_90_90049-a. PMID: 2307882. Kahler DM. Fractures and dislocations of the base of the thumb. J South Orthop Assoc. 1995 Spring;4(1):69-76. PMID: 7767680.
Livesley PJ. The conservative management of Bennett’s fracture-dislocation: a 26-year follow-up. J Hand Surg Br. 1990 Aug;15(3):291-4. doi: 10.1016/0266-7681_90_90006-p. PMID: 2230493.
https: //upload.wikimedia.org/Wikipedia/commons/thumb/7/7f/Metacarpal