My 16 year old injured her thumb playing volleyball 4 days ago. She was trying to hit balls being spiked downward at the net, but instead of hitting with her forearm, she didn't reach far enough - being hit several times on her lower thumbs and wrists. The balls would hit her flattened thumbs which were facing upward. The balls were spiked hard enough, that at the end of her volleyball clinic, the balls that did hit her forearms broke blood vessels. Her thumb swelled and was bruised. She was unable to move it and is still painful. Today is the 1st day she can bend it some. We iced it and took ibuprofen 3 days.
X-rayed day after injury. "...small osific density at the ventral side of the interphalangeal joint of the thumb, [which possibly could be a] small avulsion fracture fragment. [The source of fragment is unknown]."
How could the radiolgist not know if it is a fracuture or not? If unable to see a fracture on the views taken, who should ask for additional view (side and or front) to find the possible source of this fragment? The orthopaedic examined my daughter and viewed the films, I never saw him read the radiologist report - I brought films/report to the office and they sat in the room with me till he came in. The arrow an the film was pointing to the top thumb joint which was not injured. The ortho pointed this out and said it can't be broken as saw no fracture on the film and it wasn't hurting my child - the 2nd joint was. So he felt it was just sprained and said come back in 3 weeks. What concerns me is the small bone fragment noted in the Radiology report which I and my daughter could see on the film by her lower joint - its a small solid form floating - not attached to any bone. We are not medically trained but we could tell it wasn't where a piece of bone should be.
Should I be concerned? If we come back in 3 weeks for a follow-up as the ortho requests, is it possible she could later develop arthitis or immobility or lack of full range of her thumb if the break is from the front side of the joint or if this fragment works its way back into the joint improperly? If treatment is needed, should it be done before 3 weeks. This is her writing hand, and she plays the violin & piano. Also, the ortho said her growth plates are fuse in her hand.
If you are worried about this : ask the Orthopaedician if your daughter can still wear a spint, for finger fractures there is no need to do a plaster and in most cases of avulsion fracture if it is aligned by just using a splint.
If the avulsion is small and is aligned sometimes orthopaedicians do not advice anything.
You can always take another X-ray and second opinion to be rest assured.
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