A dislocated thumb occurs when the bones forming a thumb joint are forced out of their normal alignment. This can happen at either the interphalangeal (IP) joint, closer to the fingernail, or the metacarpophalangeal (MCP) joint, at the base of the thumb. A dislocated thumb can impact daily activities due to its importance in hand function. These injuries result from forceful trauma, such as a fall with an outstretched hand, or from high-impact sports where the thumb is bent backward or jammed.
Recognizing a Dislocated Thumb
Identifying a dislocated thumb involves observing visual cues and physical sensations. A sharp pain immediately after the injury is a common symptom. A visible deformity, such as a crooked, misaligned, or out-of-shape thumb, is common. Swelling and bruising around the affected joint are also common.
Beyond visible changes, a dislocated thumb causes functional limitations. Movement of the thumb joint becomes difficult or impossible, and attempting to bend or straighten it can be very painful. The thumb may feel abnormally loose or unstable. Nerve compression or damage during the dislocation can lead to numbness or tingling in the thumb or surrounding areas. This combination of pain, visible deformity, and impaired function helps differentiate a dislocation from a sprain, where bones remain in alignment.
Immediate Steps After Injury
If you suspect a dislocated thumb, take immediate steps to manage the injury before professional medical attention. Applying ice to the injured area reduces swelling and pain. Elevating the hand also minimizes swelling. Immobilize the thumb to prevent further damage.
Do not attempt to “pop” the thumb back into place yourself. This can damage ligaments, tendons, or lead to fractures. Seek prompt medical attention for proper diagnosis and treatment.
Professional Assessment and Care
Professional medical assessment is important for proper healing and to prevent long-term complications. A doctor will conduct a physical examination and order an X-ray to confirm the dislocation and rule out any associated fractures, which are common with this type of injury. The primary treatment involves reduction, where a medical professional gently manipulates the bones back into position. This may be done with a local anesthetic to manage pain.
After reduction, the thumb is immobilized in a splint or a thumb spica cast for several weeks. This protects the joint and allows damaged soft tissues, such as ligaments, to heal. If closed reduction is unsuccessful, or if there are severe ligament tears or bone fragments, surgery may be necessary to realign the joint and repair damaged structures.
Healing and Rehabilitation
Recovery involves healing and a gradual return to function. Following reduction and immobilization, the thumb remains in a splint or cast for three to six weeks to protect the joint. During this time, pain management strategies may be recommended.
After immobilization, rehabilitation exercises are introduced under the guidance of a physical or hand therapist. These exercises help restore the thumb’s full range of motion, improve flexibility, and rebuild strength. While mild pain and swelling can persist for several months, most individuals can gradually return to their normal activities with proper treatment and adherence to rehabilitation protocols. The entire healing process, including the resolution of symptoms, can take several months.