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Broken thumb
















Which bones are in a thumb?

The thumb is essentially made up of two bones. The first bone, called the distal phalynx, is from the thumb tip to the joint. The other bone, called the proximal phalynx, runs from the joint to meet the first metacarpal bone - this is where the web of the hand is.


How can a thumb be broken?

One of the common ways to get a broken thumb is from a fall, such as from a simple trip or from a sports related injury.

In a similar way, a twisting motion or a force that causes the thumb to bend backwards can result in a break. This is often seen in sports such as rugby or skiing, or when catching a ball in basketball.

The thumb can also be broken from direct trauma, such as in a car accident. This can also be seen in sports such as cricket, when a fast delivered ball hits the batsman's thumb.

Occasionally, a thumb can be broken by punching a person or object, especially if the thumb was clenched inside the fist when punching.


How can I tell if my thumb is broken?

The first symptom of a broken thumb is pain - this is worse when the thumb is pressed or moved. A sprained thumb can also cause pain though so this is not 100% reliable.

If your thumb is mis-shapen or bent at a sideways angle, then it is likely to be broken.

The only way to be sure is with an x-ray. For this reason, if you have any concerns about having a broken bone, always seek medical advice.


What is the treatment for a broken thumb?

This depends on a number of factors, including the type of break, your age, job, hobbies etc.

The most common form of treatment is by a splint often in the form of a simple plastic splint or plaster cast. This is often for about 3 weeks, but longer may be needed according to your break.

If this treatment fails or if your break is not suitable for splintage, then thumb surgery may be needed.



What surgery may be needed for a broken thumb?

  • K-wires - Kirschner, or 'K' wires are thin metal rods that are passed across the broken thumb bones (also known as 'pinning'). These hold the break in place until it is healed, usually three weeks later. The wires are usually left with a short length exposed at the skin, and can be removed with very little discomfort by simply pulling them out with special pliers. The wires need to be kept clean while they are in place, as bacteria could otherwise track to the broken area to cause a bone infection - this is very hard to then treat and could lead to serious consequences

  • Plate fixation - small metal plates are used to span the broken thumb bones, being held in place with small screws. The plates may be left in the thumb permanently, often un-noticed, although may occasionally need to be removed at a later date

  • External fixation - complex thumb breaks, especially around the thumb joint, may need this form of treatment to hold fragments in place while they heal. Usually, a thick pin is placed through the skin into the bone either side of the break. A metal bar then spans between the pins, keeping them and therefore the bones still. This is kept in place until the break is healed, usually three to four weeks.


What complications can occur with a broken thumb?

  • Delayed union - this is where the break takes longer to heal than expected. Whilst this can be an inconvenience, it still results in a fixed bone

  • Mal-union - the broken bones heal in a poor position. If this causes problems with thumb function, then further procedures on the thumb may be needed

  • Non-union - the broken bones do not heal, even after many weeks. Further procedures may be needed

  • Infection - infected bone is called osteomyelitis, and can be extremely hard to treat. A lengthy course of antibiotics or further surgery can clear the infection, although occasionally the infection does not clear and can even, in a worst case scenario, lead to amputation of the thumb

  • Stiffness - this is a common result of having a broken thumb, especially if the joint itself has been broken. Due to a combination of splinting and the break itself, the affected thumb may never gain the same movement as before the injury. Physiotherapy helps to reduce this risk

  • Pain - well-healed broken bones often cause little problem, although it is quite common to get 'niggling' aches and pains in the fracture area, especially during cold weather or when using the hand for heavy work or writing


Other relevant SurgeryWise articles: fingertip breaks, broken fingers, fractures, hand surgery, mallet finger, broken knuckle strapping




Any procedure involving skin incision can also result in unfavourable scarring, wound infection, or bleeding. This list of risks is not exhaustive, and you should discuss possible complications with your specialist. Whilst these risks will seem very worrysome, and indeed can be serious, it should also be borne in mind that many people have no postoperative problems whatsoever.

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