Pain, stiffness & mild swelling on thumb.

43-year-old female presented 3 weeks after a fall while intoxicated. Pain, stiffness, mild swelling to medial aspect of thumb. She has no medical hx other than mild chronic pancreatitis, for which she takes pancreatic enzymes. And, depression managed on Effexor. What would be the best plan of care for this patient?


No obvious fracture Check scaphoid fossa tenderness Commercially available thumb spica splint for three weeks Analgesics Chymoral If symptoms persist after 3weeks get a CT

No # Seen. Analgesic antiinflammatory orally. Soluzyme TDS. Multivitamin and antioxidant orally. Local support ( thumb spica 3 week ) Or surgical intervention ORIF

Thanks Dr Shivraj Agarwal

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Fracture proximal 1st metacarpeal bone Bennetts fracture. Percutaneous pinning or ORIF. following thumb spica 6 weeks

There is dislocation of proximal phalanx of thumb . Give thumb spika and antiinflammatories

Proximal phalanx of thumb dislocated Soft tissue injury

Need to assess scaphoid metacarpel ligament injury?

Thanx dr Ashok Leel

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?crack at base of 1st metacarpal.ct scan advisable.


Falls from more than 20 feet usually result in a trip to the emergency room, but even low-level falls can cause serious head injuries, according to the American College of Surgeons. The median lethal distance for falls is four stories or 48 feet, according to the reference book Trauma Anesthesia.

evaluate the patient clinically to ascertain the cause of pain till u can evaluate urself or get her to an orthopaedician temporary relief can be obtained with a thumb spika splint.

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