One of the most difficult to tolerate and quite dangerous is considered to be a fracture of the thumb. Despite the fact that he is the only finger, which is located separately according to the anatomical location, its role in the functioning of the hand is very large. The activity of the brush largely depends on the capabilities of just this finger. It accounts for almost half of all hand functions.
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 species is characterized by concentrated and sharp destruction of bone tissue. In another form, a fracture may result from prolonged fracture, as well as cracks formed earlier.
All bone fractures by type of damage can be divided into the following types:
- Helical - on an x-ray as a result of a fracture of the thumb, you can consider the formed acute angle. The resulting fragments in this case will be directed in different directions from the bone.
- Oblique - on the x-ray, you can see a clear image, which shows the presence of an acute bony lobe, as well as a slice located at an acute angle.
- Cellular - this injury is characterized by the presence of at least three pieces of bone tissue at the base of the fracture. In the picture between the chips, a gap remains visible. Such voids can be both vertical and horizontal.
- A longitudinal fracture of the thumb is a rather rare injury, with it the finger bone is divided 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, a fracture occurs across, and not at the base of all bone tissue.
Separately classified traumatic fractures. A thumb injury can be:
- Open. This is a fairly severe form of injury. In this case, all bone fragments through the skin cover are visible along the fracture line. The severity of this ailment is due to the fact that the risk of infection of both the flesh and bone tissue with an infection increases. For the distal and proximal phalanx, the risk of acute osteomyelitis is increased.
- Closed. It is considered a more successful type of fracture, in which there is no damage to the soft tissues. Shards are placed exclusively at the site of injury.
Depending on how the thumb is broken, a decision is made to conduct 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 onto a limb. During the fracture, you can get a dislocation and a bruise of the finger on the hand, which will further exacerbate the current situation. You can get this type of injury due to the fall of a weighty object on the hand or getting it into the moving mechanisms.
The localization of injury in this case can be very different. Fractures are located inside the joint or may be divisory, as they always accompany an unsuccessful outcome.
Risk groups
Quite often, a fracture of the thumb occurs in the following categories of citizens:
- Children.
- Professional athletes who are most often involved in basketball, boxing or volleyball.
- Patients with osteoporosis.
- The elderly.
- People working with dangerous cars.
- Menopausal women.
Symptoms of a fracture of the thumb
- Immediately after acquiring an injury, a person feels pain and severe burning in the area of the thumb.
- On examination, it can be observed that the injury zone will be greatly increased due to the formation of edema.
- At the time of examination by a doctor, he will definitely see redness of the epidermis at the fracture site.
- In some victims, due to the fact that the finger is swollen and the bone moves slightly, the phalanx deviates to the other side.
- The finger can be very pale with a hematoma.
- Hemorrhage often forms under the victim’s fingernail, which will subsequently lead to detachment of the nail plate.
- A person who is injured partially or completely disappears from the possibility of active movement. However, in some patients, on the contrary, one can observe pathological mobility of the thumb on the hand.
- Quite often, a fracture of the phalanx of the thumb is accompanied by a change in the integrity of the nail layer.
- At the time of palpation, you can hear crepitus of debris (a characteristic crunchy sound that occurs when they rub against each other).
- After the injury, the axis of the thumb will be violated without fail.
- One of the symptoms of such a problem is the intensification of pain with a gentle tapping by the doctor on the top of the finger towards its base. It is necessary to remember: if there is a fracture of the thumb with an offset, then such a procedure is strictly forbidden, as it can aggravate the situation.
- Sometimes doctors without an x-ray can palpate to identify a bone defect in the injury zone.
- Upon examination, you can consider that the injured finger has become a little shorter in relation to a healthy one.
- At the time of impact with heavy objects on the finger, a visually pronounced deformation of the bone is formed.
- Due to the fact that the thumb on the arm at the base is very sore, the function of the hand will necessarily be impaired in the victim.
- Palpation of the injured place causes a very painful sensation in the patient.
- In the presence of open fractures in the patient from the wound surface, parts of the broken bone can be visualized and active bleeding due to vascular damage can be present.
Diagnostics
In order to understand how to determine a fracture of the thumb, you must be a doctor. It should be noted that the diagnosis of this problem is not always simple. But very often, literally in appearance without using a picture, you can diagnose the presence of an ailment. An x-ray is most often needed only to confirm certain symptoms.
Diagnosis is complicated only when medical care was provided incorrectly or was not performed at all. And also in the case when the finger is swollen, palpation becomes problematic.
First aid
If possible, you must immediately go to the emergency room. In the absence of this, it is mandatory to call an ambulance.
There are times when assistance must be provided immediately before an ambulance arrives. In this case, you need to know certain rules.
The joint of the thumb on the hand always hurts because of the fracture, but because the adrenaline rushes into the body, the victim does not feel this. However, after 2-3 minutes the action of the substance ceases. In the place of a fracture or a bruise, very strong sensations arise that a person barely tolerates.
After determining the focus, you need to "freeze" the place. For this, a cold object is used, which is an analog of anesthesia. It will not be possible to completely eliminate all unpleasant sensations, but it will be possible to lower the post-shock position.
If there are pain medications at home, then it is required to give them to the victim in the amount indicated in the instructions.
Regardless of the fracture or bruise of a finger on a hand, it is imperative to fix the limb. A special material is used to apply the tire. Most often it is not at hand, therefore it will be sufficient to fix the thumb to the adjacent one. When fixing, one must not forget that in the future the phalanx will increase in size, because it will swell, and an excessively tightened bandage will close the flow of blood to the limb. Therefore, fixing is required very carefully with the calculation of the stock.
Conservative treatment
Any doctor should begin the treatment of a fracture of the base of the thumb with an offset only by comparing all the fragments.
Initially, local anesthesia is performed using Lidocoin or Novocain, and then the doctor repositions. The doctor’s assistant extends along the entire length of one hand for the thumb of the hand, and with the other hand extends 2–5 fingers. The surgeon needs to put the bandage in the first interdigital lumen, and then, by pulling the bandage, he performs anti-traction. A similar manipulation is done for 5-7 minutes.
Further actions of the doctor are aimed at the fact that he sets the thumb in the maximum abduction position, and then puts gypsum on the thumb of the hand and the circulating bandage, which fixes the whole thumb and is fixed on the upper third of the forearm.
A patient who already has gypsum is given a repeat x-ray to confirm that everything is done correctly.
In case of a fracture without displacement, conservative therapy consists in applying the Baller splint (palm plaster tape is also very often used). Many patients are interested in how much a thumb fracture heals . With such an injury, the victim with gypsum needs to walk 2-3 weeks, and then, over the course of a month, everything is finally restored.
When a victim has a tendon damage in addition to a fracture, it is initially necessary to achieve bone fusion, and after that the doctor deals with tendon plastic surgery.
Surgical treatment
The operation with such an ailment is performed using screws and knitting needles. It may include two or one stage:
- With one-stage osteosynthesis, the patient is fixed with bone fragments of various devices that remain on the bone for life. The regeneration process takes about a month and a half.
- In two-stage osteosynthesis, all fasteners are removed 3-4 weeks after surgery. Recovery in this case will take two months.
After a plaster is removed, a person is required to prescribe rehabilitation measures, which include massage, physiotherapy and physiotherapy.
When the patient has a thumb sore on the arm at the base, he is shown thermal procedures, which include baths with salt and dry heat.
Using a finger lock
The doctor deals with the procedure for comparing the fragments, initially anesthetizing the fracture site. Regardless of the severity and type of fracture, an important stage in therapy is the immobilization of the damaged area by special methods:
- Gypsum dressing - it is located from the upper part of the forearm to the end of the injured finger, which must be partially open to track the presence of normal blood circulation.
- A good alternative to gypsum is a fiberglass rigid tire, which is most often used in difficult cases. A similar retainer is placed, starting from the wrist, to the end of the phalanx and firmly fixes it.
- More and more often recently, a special orthopedic fixator, orthosis, has become especially popular. 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 fit. For a thumb with an injury, the orthosis is made of a special form. For him, certain materials are used, which, unlike a plaster cast, are quite comfortable. The latch is easy to remove, but you need to know that such manipulation is performed exclusively under the supervision of a doctor. Otherwise, the regeneration process may take a long time.
How much gypsum is worn?
Closed fractures with the right help do not pose any particular danger, so the period of wearing such a bandage is 2-3 weeks. Full regeneration occurs after 3-4 weeks.
For fractures of medium complexity, it will take 6-8 weeks. The first four weeks are aimed at gypsum immobilization.
Recovery from complex fractures reaches ten weeks. Wearing plaster using knitting needles and screws takes up to six weeks. If complications arise during rehabilitation, this period may increase.
Rehabilitation
The recovery process is always one of the most difficult stages. After applying gypsum, muscles begin to suffer greatly. Atrophied tissues need further renewal. Often with a partial or complete decrease in brush function, it is prescribed:
- physiotherapy;
- massage;
- gymnastics.
All of these procedures are performed 3-4 times a day. Particular and main attention is required to be paid to physiotherapy, since it most quickly restores lost muscle and tendon functions, after which a person can lead a familiar lifestyle.
The purpose of physiotherapy
If the joint of the thumb on the arm hurts after a fracture, such procedures are very necessary. They are directed:
- to relax the smooth muscles of the vessels;
- a decrease in pain;
- softening of ligaments;
- increased blood circulation of tissues;
- removal of edema;
- reduction of inflammation in the 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 advised to use non-narcotic analgesics in tablets (Paracetamol, Analgin, Pentalgin). When the patient has not developed ligaments, then his finger will be difficult to bend. If all the bones of the thumb grow together correctly, then paraffin baths, massage and physiotherapy exercises are prescribed, and ointments such as Piroxicam or Chondroxide are also to be rubbed into the finger.
Prevention
Often, a fracture of the thumb leads to hand dysfunction, so it knocks a person out of the usual way of life for a long time. It takes a lot of time for therapy, so it's best to try to avoid such injuries using simple preventative measures:
- A balanced and proper diet is the key to the health of the whole organism. The more a person consumes vitamin D and calcium, the less likely his bones are to fractures. It is required to include cottage cheese and dairy products in your diet, it is useful to use broccoli, legumes, nuts, white cabbage and sesame. In addition to the presence of calcium, magnesium is present in these products, which strengthens and restores bone tissue.
- Bad habits negatively affect the whole body. Nicotine does not allow to absorb many trace elements, and alcohol provokes traumatic situations that just lead to fractures and bruises. Therefore, maintaining a healthy lifestyle is especially important for human life.
- Many injuries result from human negligence. Therefore, do not neglect workplace safety. It is necessary to use automatic tools and devices carefully.
- Continuous exercise helps strengthen the hands. It is required to remember that any activity should be begun only with a warm-up. Before giving loads to the hands, joints and phalanges of the fingers need to be warmed up well, otherwise the presence of injury cannot be avoided. To do this, you can use simple exercises:
- rotation of the brushes in a circle;
- the same rotation, but the hands should be in the lock;
- dynamic compression in the fist of the palms.