Sunday 18 November 2012

The Thumb

Reason for this bizarre topic.....?! I may have cracked/damaged the ligaments in my thumb and was wondering what could be the consequence of dislocated/breaking my thumb!

-Thumb Dislocation
"A dislocation is a separation of two bones where they meet at a joint. Joints are areas where two bones come together" (http://www.nlm.nih.gov/medlineplus/ency/article/000014.htm). In terms of the anatomy of the thumb, look below.


http://www.ski-injury.com/specific-injuries/thumb
 
Therefore a dislocation in the case of a thumb concerns the metacarpal bone and the bone below it or the metacarpal with the proximal phalanx. "In the case of a serious dislocation, the joint becomes unstable, and the function of the thumb is definitely altered. The joint of the thumb, between the metacarpal and the first phalanx, has two major ligaments (ulnar collateral ligament and dorsal collateral ligament) which may suffer from trauma and even rupture" (http://www.hand-clinic.com/pop_emergency/thumb_dislocation.htm).

-Treatment of a thumb dislocation.
Non-surgical treatment such as "orthopaedic treatment: immobilisation with a fixed plaster cast or resin to block the metacarpophalangeal joint of the thumb, with the wrist released. This immobilisation should be kept for three weeks. After removal of the immobilisation, the patient will gradually regain thumb motion, and should take care for two months. A few rehabilitation sessions [may] be needed" (http://tinyurl.com/btmf36n).

However surgical treatment may be necessary depending on the extent of damage;




As can be seen from the diagram above (http://tinyurl.com/btmf36n) an incision can be made (on the inside of the thumb in this case) and a screw can be put in place to hold the two bones together.


-Broken Thumbs (Fracture)
"Broken thumb injuries are highly debilitating and a common cause of thumb pain and hand swelling" (http://www.orthoped.org/broken-thumb-injury-symptoms-and-treatment.html).

"The thumb, being a vital part of the hand, dictates the necessity to achieve a nearly perfect reconstruction of a broken thumb" (http://tinyurl.com/d5eod44).  The options involve  "thumb joint replacement, and artificial thumb reconstruction" (http://tinyurl.com/d5eod44) or as we saw above, using 'orthopaedic bone screws'. The impact of this surgery can be seen in the patient below.



However "the common protocol, is to bring the broken ends of the bones or ligaments to their natural alignment as much as possible, with or without surgery. The next step is to keep them immobilised in this position until the fusion of the broken ends" (http://tinyurl.com/d5eod44).

I am very glad that I have neither of these but I do have the pain symptoms and swelling usually associated with both. the swelling is a "delayed symptom of thumb injury due to insufficient space in the thumb to accommodate the inflammatory fluids" (http://tinyurl.com/d5eod44).
 

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