How can I tell if it's a broken thumb?

December 5, 2008 10:10 PM

How do you know if your thumb is broken? When should you see a doctor?

About a week and a half ago, my husband fell and jammed his thumb quite hard (pulled by our four-month-old puppy who was anxious to get on her walk).

He thought it wasn't a big deal at first, but his thumb has stayed swollen and painful for the past 10 days. He does not have full range of motion (but has some motion). Often times, he says it feels just fine - but about once or twice a day he'll jam it against something while washing dishes or opening a door and he will feel intense pain. It does not seem to be getting any better, and the swelling has only increased over the past few days.

Our insurance situation is a little complicated right now, so we don't necessarily want to go to a doctor if it's not necessary. Any advice on how to tell if it actually is broken (without getting an x-ray)?

posted by aether516 to health & fitness (13 comments total)

When things are getting worse, not better, over time, I definitely go see a doctor.
posted by grouse at 10:52 PM on December 5, 2008 [1 favorite]

In your husband's situation, I would be going to see a doctor right away.
posted by The World Famous at 11:30 PM on December 5, 2008

IANAD (but am former EMT). There's no way to accurately diagnose a fractured thumb without medical examination and imaging (x-rays). In some cases, delayed treatment can impede healing and even increase a one's chances of later developing arthritis. Fracture symptoms may include severe, focused or dull, radiating pain; swelling; limited mobility; tenderness; misshapen form; and/or numbness.

But an ulnar collateral ligament injury to the thumb can also provoke similar symptoms, and may require splinting (or in severe cases, surgery).

Long route to a short recommendation: have a doctor x-ray and examine the injured thumb. And in the interim (though this is no substitute for an in-person physician's visit), you may wish to Ask the Free Virtual Doctor (who looks a little like Michael Douglas) what he thinks about the thumb injury.
posted by terranova at 11:47 PM on December 5, 2008 [1 favorite]

It's getting worse. If you don't have insurance then waiting longer will result in more bills, not fewer.
posted by Ookseer at 11:48 PM on December 5, 2008

Any time an injury gets worse over time, or even if it simply fails to heal, it's time to see a doctor. You don't want to mess with joints - they are pretty darn important to one's quality of life - send your boy out for an X-ray.
posted by The Light Fantastic at 11:51 PM on December 5, 2008

Just an idea-- on the off chance you know a dentist well, you could ask them to x-ray the digit in question.
posted by alexei at 12:30 AM on December 6, 2008

Even if it's not broken, it's still not getting better.

Go see a doctor.
posted by HFSH at 3:35 AM on December 6, 2008 [1 favorite]

I fractured a finger a year or two ago and the pain you're describing sounds nauseatingly familiar - especially the intense pain when you 'jam' it against something - to the doctors with him!
posted by Chairboy at 5:47 AM on December 6, 2008

i did the same thing about a year ago, except it was a finger, not my thumb. didn't see a doctor. it continued to hurt for a few days, especially when i jammed it. finally went to the pharmacy and got a simple splint rig, and splinted it for a week or two. that kept it from jamming, and allowed it to heal. now i don't even remember which finger it was.
posted by lester at 7:59 AM on December 6, 2008

There's really nothing else you can do unfortunately at this point but go get checked out. I'm a doctor and if this happened to me, I'd go get x-rays and medical evaluation especially if my pain and functional limitations weren't improving over that time period. There's just no other way to reassure oneself that it's no big deal, even with my medical training. That's especially true when your husband has all the warning signs of a fracture at this point.

Fractures in the hands/fingers are nothing to shrug off. In many cases surgery is even required to fix things, otherwise one risks potentially permanent loss of function.
posted by drpynchon at 8:32 AM on December 6, 2008

I broke a thumb at age 20 and didn't get it looked at. After three days, when it was still painfully, insanely swollen, I went to the doc and they said "well, you fractured it." At that point, there was nothing to do other than rebreak and set it, which I wasn't interested in.

So they taped it, and it healed. 18 years later, I have a slightly funny-looking thumb joint which 'clicks' when I rotate it, and have a little less range of motion than I do on my other hand. it hasn't been a big deal, but I wouldn't be surprised to have joint pain there when I get older.
posted by Miko at 1:41 PM on December 6, 2008

If he went to a doctor right now all they could do is rebreak it. I broke my thumb about 18 years ago and waited about a week to go to the doctor. He asked if I wanted to rebreak it and I said no so he just put it in a cast for 6 weeks. It took me about a year (maybe longer) to regain full movement (probably due to the ligament damage that accompanied it) but now it's just fine. If I were your husband and desperately didn't want to see a doctor I would immobilize it with an ace bandage in the same shape his hand hangs normally, that's what the doctor did for me. Of course IANAD.
posted by any major dude at 5:21 PM on December 6, 2008

EDIT: we went to the doctor and it was sprained, not broken. Thanks to all for the advice.
posted by aether516 at 10:34 AM on December 7, 2008