Sprained thumb

The thumb sprain can be divided into three grades depending upon the severity of the sprain:

• Grade 1 sprain: The sprain is mild as in this grade as the ligaments are stretched but intact.
• Grade 2 sprain: This sprain is moderate as the ligaments are torn but only partially. The person might not be able to move his/her thumb at this point.
• Grade 3 sprain: The sprain is severe as the ligament is either pulled off the bone or is completely torn. These sprains require surgical care. Sometimes in these sprains, while tearing off, the ligament takes away a chipped part of the bone with it, which is then called an avulsion fracture. 

The symptoms of a sprained thumb are:

• Thumb pain
• Pain in the surrounded area
• Bruising of the thumb
• Swelling of the thumb joint and palm
• Inability to write or hold anything with the help of the thumb

Thumb sprains can be the result of a sudden and strong force being exerted on the area, that stretches or detaches the ligaments of the thumb. This could happen during a fall or an accident. 

This injury is mostly seen in athletes, skiers and people who are involved in sports like football, volleyball, basketball, judo and netball.

Thumb sprain is mostly the result of an accidental injury, therefore there is no specific prevention to it. Though, if you are playing a sport which allows you to wear protective gear like gloves and guards, please do so to prevent the spraining of your thumb.

Skiers should wear the right-sized protective gloves which might prevent thumb injury in case of a fall.

Your doctor may ask you a couple of questions about the incidence, the pain and the beginning of the swelling in order to make a correct diagnosis.

Your doctor will also do a physical examination of the thumb to know the extent of the condition. For instance, on moving the thumb, if the joint looks completely loose and unstable then it means that the ulnar collateral ligament has torn off completely.

X-rays can be advised by the doctor to check for avulsion fractures.

The treatment begins with RICE or rest, ice, compression, and elevation therapy. 

• Rest should be given to the injured hand. Restrict the movement of the hand by taping the thumb in place, to the rest of the hand.
• Ice application should be done for the first 24 to 48 hours in order to reduce the inflammation and swelling. Direct application of ice to the injury site can be done. 
• A compression bandage or thumb splints should be used to support the joint. This would not only support your thumb but also help in reducing the swelling.
• Elevation of the injured site with a more appropriate thumb spica cast could also be done to prevent the back bending of the thumb. 

If the ligament is partially torn, it takes 2-3 weeks for the ligament to heal and the thumb to regain its full range of motion.

In case of a complete tear of the ligament, surgery is done to reattach the ligament to the bone. In the case of avulsion fractures, the surgery involves reattaching the bone and ligament with the help of pins, screws or bone anchors.