A dislocated thumb occurs when the bones forming a joint in the thumb are forced out of their normal alignment. This type of injury is often quite painful and requires prompt attention. Common causes include falls, accidents, and sports injuries, particularly those involving hyperextension or direct impact to the thumb. When the thumb is bent backward beyond its usual range of motion, the soft tissues, such as ligaments, that stabilize the joint can tear, leading to the dislocation.
Immediate Actions
A dislocated thumb presents with several symptoms. The thumb will typically appear visibly out of place, crooked, or deformed. Intense pain is usually present immediately after the injury, along with noticeable swelling and bruising around the affected joint. Movement of the thumb joint may be restricted or impossible, and numbness or tingling can occur if nerves are affected.
Before professional medical help arrives, calmly immobilize the thumb to prevent further damage. Apply ice wrapped in a thin cloth or an ice pack to the injured area to reduce swelling and pain. Elevating the hand above the heart also helps decrease swelling. Avoid attempting to force the thumb back into place yourself, as this can damage blood vessels, tendons, nerves, and ligaments. Seeking professional medical care as soon as possible is important for proper diagnosis and treatment.
Professional Medical Care
Healthcare providers will typically begin with a physical examination to assess swelling, deformity, and range of motion. X-rays are commonly used to confirm the dislocation and rule out associated fractures. For complex cases or to evaluate soft tissue damage, advanced imaging like CT or MRI scans may be necessary.
The primary treatment for a dislocated thumb is reduction, where medical professionals realign the bones back into their proper position. This is often performed as a closed reduction, meaning realignment occurs without surgery. Before the procedure, a local anesthetic is typically administered to numb the thumb and minimize pain. For complex dislocations or if closed reduction is unsuccessful, open reduction surgery may be necessary to directly reposition the tissue and bone. After reduction, another X-ray is often taken to confirm successful alignment.
Following reduction, the thumb is immobilized to allow the joint to heal and prevent re-injury. This usually involves wearing a splint or cast, such as a thumb spica splint, for several weeks. The splint helps stabilize the joint while the tissues, particularly ligaments, recover. Pain management strategies, including over-the-counter or prescription medications, may be recommended to manage discomfort during initial healing.
Recovery and Avoiding Re-injury
The healing timeline for a dislocated thumb varies, but ligaments typically take approximately six to eight weeks to heal. Full recovery, including the return of complete function and resolution of pain and swelling, may take several months, sometimes up to 18 months. During this time, the thumb should be protected from re-injury.
Rehabilitation plays an important role in regaining strength and flexibility. Once cleared by a doctor, gentle range-of-motion exercises are introduced, often guided by a physical or occupational therapist. These exercises help restore the thumb’s normal movement and prevent stiffness. Gradual return to daily activities is advised, avoiding strenuous use of the thumb too soon to prevent complications.
To prevent future dislocations, strengthening exercises for the hand and wrist muscles are beneficial. Using protective gear, such as athletic tape, thumb guards, or splints, during sports or activities that could put the thumb at risk can offer additional support. It is also important to be aware of proper lifting techniques and avoid putting excessive stress on the thumb. Persistent pain, numbness, or continued stiffness during recovery warrant further medical evaluation.