Presentation
Left thumb pain and swelling after tripping and falling down the stairs.
Patient Data
Frontal, oblique, and lateral radiographs of the left hand demonstrate a nondisplaced transverse fracture of the sesamoid adjacent to the thumb metacarpophalangeal joint. This is confirmed on the magnified view of the left thumb. There is osteoarthritis at the thumb carpometacarpal joint.
Case Discussion
There are typically five sesamoid bones in the hand, two of which are located at the MCP joint of the thumb. These bones help redistribute forces on the muscles and tendons of the hand to decrease strain. Fractures of the thumb MCP sesamoid bone are uncommon and may be caused by hyperextension of the thumb and/or direct trauma. These fractures may not always be apparent on AP and lateral radiographs. Oblique views may make these fractures more visible. Delays in their diagnosis can result in prolonged pain and recovery time.
This patient presented with a transverse fracture of the sesamoid bone after a fall. A velcro splint was utilized to stabilize the joint. Taping has been shown to be useful in nondisplaced and minimally displaced fractures. Immobilization is effective in allowing sesamoid bone fractures to heal.
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