Ok the story goes like this: About a month ago (October 18, 2011) I had a motorbike accident. I was OK but after I took off my gloves I noticed my left thumb looked a bit weird. I went to A&E where I had x-rays and was told I had an avulsion fracture at the base of the thumb and a break at the top of the thumb (on the distal phalange) and they put an Elastoplast splinter.
1 week later I had to visit the UCLH fracture clinic where an orthopaedic told me it should heal with conservative treatment and they changed the Elastoplast splinter with a plastic one.
3 weeks later (total 4wks) I went back and had a new set of x-rays. This time a different orthopaedic came over, he took the splinter off, and very simply told me that because the bone has gone in the joint I will not be able to move the tip of my thumb anymore but a few degrees..
This obviously shocked me, especially after all the reassurance I was given before, and since I am in general quite active (do drums, boxing). So, I immediately visited a private orthopaedic for a second opinion who had another set of x-rays done:
Left thumb bottom aspect
Left thumb side aspect (as you look the hand from the top)
He had a different opinion. He thinks that there is enough room in the joint for movement and that I will probably be able to bend it again but sent me for an MRI scan as well, which I am having next week.
My thumb at the moment feels locked on that position and is still bruised at the joint but with a bit of slow repetitive movement exercise I managed to get a few extra degrees of movement than when I got the splinter off (tendons seem to be OK). So, my questions are:
1) Do you think that I will be able to bend my thumb anymore?
2) Is there any exercise I should be doing?
3) Should there have been a different course of treatment in the initial weeks?
This is a fracture of the articular surface of the DIP joint of the thumb. On the images you provided, the fracture appears to involve about 40% of the articular surface with a reasonable amount of displacement. Although the bone will certainly heal, you may lose some motion and may be subject to post-traumatic arthritis in the future. At this point, the fracture should be fairly well healed; I would likely institute a range of motion program and observe your progress.
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