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Careful early detection and management of thumb injuries in the ED is important for minimising any long-term morbidity associated with the injury Most simple fractures can be immobilised in a thumb spica splint and followed up in an appropriate hand surgery clinic This guideline covers types of thumb fracture that require specific management which differs from fractures of other digits. Rotational deformity can be assessed by comparison with the uninjured side, but Levonorgestrel and Ethinyl Estradiol Tablets (Jaimiess )- FDA difficult to appreciate in the thumb.

Subungual haematoma or displacement of the proximal edge of the nail plate out novartis logo the eponychial fold may indicate an underlying fracture.

Bennett Fracture, usually from axial loading of the thumb in patients with closed physes. ED management involves immobilisation in a thumb-spica (see below) and arranging an appointment within a week with the hand surgery team (At RCH this is Plastic Surgery)Definitive management by the hand surgery team requires reduction, usually involving K-wire insertionFracture through an open physis, involving the same mechanism and deformation patterns as in a Bennett fracture.

Management is as with a Bennett fracture, as it is usually subjected to the same deforming forces from the muscle insertions. Skier's thumb) Usually results from hyperabduction of the thumb. Examination shows bruising and swelling to MCP joint, with focal tenderness to ulnar aspect of joint and pain there with pinch grip. ED Management involves application of a thumb spica (below) and arranging early follow-up with the Hand Surgery Team (regardless of whether avulsion present or absent)Definitive Management is mostly not-operative with hand therapy, but some cases require surgical repair.

ED Management involves immobilisation in a thumb spica (with closed reduction if significantly angulated or displaced)Definitive Management requires early expert reduction by specialist hand surgery team, often with K-wire fixation. This should take place within a few days. ED Management involves immobilisation in a thumb spica and appropriate communication with the hand surgery Levonorgestrel and Ethinyl Estradiol Tablets (Jaimiess )- FDA. Follow up is with GP for most injuries, but Hand Surgery team if nailbed repair required or significant tissue disruptionSeymour Fracture These are open fractures through the growth plate with Levonorgestrel and Ethinyl Estradiol Tablets (Jaimiess )- FDA nailbed injury and displacement of proximal nail plate from the nail fold.

They are significantly less common in the thumb than in the other fingers. Management requires admission for washout, debridement, reduction, nailbed repair and antibiotics. Arthritis, particularly in the case of intra-articular fractures or delay to diagnosis Malunion Kozin Fractures and Dislocations along the Pediatric Thumb Ray Hand Clin 2006 22(1) 19-29Information specific to RCH: Thumb injuries requiring specialist input are handled here by the Plastic Surgery team.

Oxlumo (Lumasiran Injection)- FDA other centres, this may be an orthopaedic surgical team. Levonorgestrel and Ethinyl Estradiol Tablets (Jaimiess )- FDA guideline refers to 'hand surgery' to encompass both specialty fields.

How are they classified. How common are they and how do they occur. What do they look like - clinically. Findings for specific fracture types are listed in the table below 5. What radiological investigations should be ordered. True lateral, true AP and oblique views on XRay 6. What do they look like dark beans x-ray.

Fractures at the base of thumb: Bennett Fracture, usually from axial loading of the thumb in patients with closed physes. Examination will show bruising and tenderness at the thumb MCP joint ED management involves immobilisation in a thumb-spica (see below) and arranging an appointment within a week with the hand surgery team (At RCH this is Plastic Surgery) Definitive management by the hand surgery team requires reduction, usually involving K-wire insertion Fracture through an open physis, involving the same mechanism and deformation patterns as in a Bennett fracture.

X-ray: This example shows a Salter-Harris II fracture of the metacarpal. Management is as with a Bennett Fracture above. Fracture proximal shaft of metacarpal, usually from axial loading. X-Ray may show an avulsion at the UCL insertion, or may be normal ED Management involves application of a thumb spica (below) and arranging early follow-up with sida cordifolia Hand Surgery Team (regardless of whether avulsion present or absent) Definitive Management is mostly not-operative with hand therapy, but some cases require surgical repair.

Follow-up will be via hand surgery clinic Fracture through physeal plate of proximal phalanx (Salter-Harris) Examination will reveal local swelling and tenderness ED Management involves immobilisation in a thumb spica (with closed reduction if significantly angulated or displaced) Follow-up will be via hand surgery clinic within a week.

Proximal Phalanx Neck fracture Examination will Levonorgestrel and Ethinyl Estradiol Tablets (Jaimiess )- FDA local swelling and tenderness.

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