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Fell on thumb, arms swollen to elbow, thumb not moving. X-ray showed not broken. What else could it be?

DOCTOR OF THE MONTH - Feb 2014
Feb 2014
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Orthopaedic Surgeon, Joint Replacement
Practicing since : 2004
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My twelve year old son fell while playing basketball lat night. He fell on his rt hand, landing msly on his thumb side and stretched the hand as if he were pulling up on his fingers toward his nose. He felt a "zing" up to his elbow when it happened. He is unable to move his thumb - mostly due to severe pain it was X-rayed last night and we were told it was not broken, however this is the same doc I showed the fat pad syndrome and sailboat sign on my other child's elbow X-ray when he said that wasn't broken.

This morning, my son woke up with his hand, thumb and forearm hurting all the way to his elbow. Last night there was also dimpling on the bottom side of his hand, near the thumb joint where it meets the hand. His hand, thumb and arm is swollen to his elbow.

I have difficulty believing this is a simple sprain.....thoughts?
Posted Tue, 14 May 2013 in Bones, Muscles and Joints
 
 
Answered by Dr. Saurabh Gupta 1 hour later
Hello and Welcome to XXXXXXX
Thanks for writing to us.

Severe pain, swelling throughout and inability to move thumb points toward some bony injury. It might be simple hairline fracture or torus fracture(buckling of cortex). There might be possibility of missing that in the x-ray.

I suggest you to get a repeat x-ray and get examined your son by an orthopaedician.

In the interim, I suggest him to apply ice packs to the affected area,anti-inflammatory drug like motrin half tablet to reduce pain and inflammation. Avoid lifting and rest well.

Hope this helps you. Please close this discussion, if you do not have any other queries. I would appreciate your reviews about this service.

Wishing him speedy recovery...

Warm Regards.
Dr Saurabh Gupta.
Orthopaedic Surgeon.
Above answer was peer-reviewed by
 
Follow-up: Fell on thumb, arms swollen to elbow, thumb not moving. X-ray showed not broken. What else could it be? 47 minutes later
Thank you very much.....I'm fairly certain I saw a hairline fx.....but, I'm not the doc.

Could you explain the torus fx in a little more detail. I used to work in an OR...but either don't remember...or never heard of that type.

His pain is centered at the base of his hand, at the crease where the thumb meets the wrist. This is the spot I saw the "dimpling" as well.

Thanks,
XXXXXX
 
 
Answered by Dr. Saurabh Gupta 2 hours later
Hi XXXXXXX
Thanks for writing back.

In torus fx there is slight elevation (buckling) of border (cortex) of bone. This type of fracture is common in children.

Dimpling at the base of hand seems to be due to more swelling distal (towards the base of thumb) to it.

Hope I have answered your query. Let me know if you have any more concern.
Please accept my answer if you do not have further query.

Best wishes

Regards
Dr Saurabh Gupta
Orthopaedic surgeon.

Above answer was peer-reviewed by
 
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