Thumb Fractures Causes, Symptoms & Treatment Options

Overview

The thumb plays an important role in grasping objects, so a thumb fracture can significantly affect your ability to pick up and hold items.

Your thumb is made up of two bones, called phalanges. These small bones connect to a larger bone in your hand, known as the first metacarpal.

The most common thumb fractures involve the base of the first metacarpal and the area where your thumb attaches to the wrist, referred to as the carpometacarpal (CMC) joint.

Two specific types of fractures that affect the CMC joint are:

• Bennett fracture: A clean break at the base of the thumb involving the joint.
• Rolando fracture: Occurs when the bone is shattered in the same location.

What causes Thumb Fractures?

Thumb fractures are most common in these sports:

Thumb fractures usually result from trauma or sudden force applied to the thumb. Common causes include falls, sports injuries, or accidents where the thumb is bent backward or struck directly. In some cases, fractures can also occur from twisting motions or strong muscle contractions during intense physical activity.

• How the Injury Occurs: A thumb fracture often happens when the thumb is forcefully bent, twisted, or compressed. This may occur from falling onto an outstretched hand, being struck by an object, or colliding with another person. The sudden stress on the joint or bone exceeds its strength, causing a break or crack.
• Common Everyday Causes: Thumb fractures are not limited to athletes. They can also occur in everyday situations, such as:
• Falls at home or work, where someone lands awkwardly on their hand.
• Accidents involving tools or machinery that crush or jam the thumb.
• Car or bike accidents, where the thumb absorbs direct impact.
• Repetitive strain during manual labor, like construction or assembly work, can place continuous stress on the thumb joint.

These non-sport injuries can be as painful and may require similar care and recovery time.

Thumb fractures are most common in the following sports:

• Baseball: The thumb can jam or hyperextend while catching or hitting the ball.
• Softball: A fast-moving ball or an awkward bat grip can put sudden pressure on the thumb joint.
• Basketball: The thumb may bend backward if the ball hits the hand unexpectedly during a pass or rebound.
• Football: Direct impacts or falls during tackles can forcefully bend or twist the thumb.
• Hockey: Contact with sticks, pucks, or collisions can stress the joint and cause fractures.
• Wrestling: Strong grips and twisting during holds or takedowns can injure the thumb.
• Skiing: Known as “skier’s thumb,” it occurs when the thumb gets caught in a ski pole strap during a fall.
• Volleyball: Forceful ball impacts or blocking at the net can cause sudden thumb hyperextension.

Symptoms

A broken thumb will  cause immediate pain and limit your ability to grip or move your hand. Common signs and symptoms include:

• Intense pain and swelling at the base of the thumb: Soon after the injury, the area may become sore, swollen, and tender.
• Restricted or no mobility in the thumb: Bending, straightening, or moving the thumb may be difficult or impossible.
• Noticeable deformity of the thumb: The thumb may appear crooked, shortened, or misaligned.
• Extreme tenderness over the thumb: Even light pressure can cause significant discomfort.
• Visible bump or misalignment: The fractured bone may sometimes create a noticeable protrusion.
• Numbness or coldness: This may indicate nerve or blood vessel involvement.

Because thumb fracture symptoms can closely resemble a severe sprain, it is essential to see a doctor promptly for an accurate diagnosis and proper treatment.

Non-operative treatment

If the bone fragments are not displaced, meaning they haven’t shifted significantly, or if the fracture does not involve a joint, your doctor may treat the thumb without surgery.

Non-surgical treatment typically involves wearing a specially designed cast called a thumb spica cast for 4 to 6 weeks. Routine X-rays may be taken during this period to ensure the bones remain properly aligned as they heal.

Try these exercises to help your condition:

Below is a PDF of the exercise program.

Thumb Fractures

Surgical Treatment

Surgery may be necessary to treat a thumb fracture when the bones are misaligned, unstable, or involve a joint surface. It’s typically recommended if:

• The bones are displaced: The broken ends of the bone have moved out of position and need realignment.
• The fracture involves a joint: Damage extending into the thumb joint can affect long-term movement and stability if not repaired properly.
• You have a Rolando or Bennett fracture: These are complex fractures near the base of the thumb that often require surgical correction for proper healing.

During surgery, your surgeon will carefully realign the bone fragments and use pins, plates, or screws to hold them securely in place.

Two main techniques may be used:

• Internal fixation: small screws or plates are placed inside the thumb to stabilize the fracture.
• External fixation: pins are inserted into the bone and connected to a device outside the body to keep the thumb steady during healing.

These surgical methods help restore thumb alignment, promote healing, and preserve joint motion for long-term hand function.

After surgery, immobilization with a splint or cast is often necessary to protect the repair and allow proper bone healing before movement exercises begin.