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Have a fracture, numbness and pain in thumb and index finger. Is it serious?

I had a fall on February 25,2013 and hurt my hand. I m not sure how I landed on it but put it out to break my fall. Had an xray 3 hrs after injury and it was negative for any fracture . I have pain in my thumb into a V pattern that goes up into my index finger and across mt wrist . Pain has decreased some since but does return and aches at the bottom of my thumb and over to the long bone in my hand that connect my index finger. I have a burning sensation in that area as well. I can move it with little to no discomfort but again at times it will really be painful. My grasp is very weak and uncomfortable. The injury happpened at work so they requested I see a physiotherapist to do a Functional ability assesment and the therapist feels that I could have a possible scaphoid fracture and has suggested I go back for an xray ten days from the injury date. Just wondering what you opinion is on this with me having little pain with movement but at times more severe and almost also a dull ache at rest. In the evening the pain is worse and does require ice. There is still slight swelling on the under side and side of my thumb and in the separation area between thumb and index finger. I am working again and use my hands a great deal in work as a support worker for individual that are physically disabled and fully dependent. I did notice an increase in pain after my first and only shift back at work yesterday. Would you agree that this could be a scaphoid fracture or could it only be a sprain . I was not given any treatment, brace, support or anything.
Asked On : Tue, 5 Mar 2013
Answers:  2 Views:  198
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Orthopaedic Surgeon, Joint Replacement 's  Response
Jul 2013
Hi, thanks for writing to HCM.

After going through the entire description, I also suspect a scaphoid fracture. In most patients the xrays are negative for a scaphoid fracture as the fracture lines are not visualized clearly in the acute setting.

An xray taken after 10 days of initial injury will give a correct diagnosis of a fracture as the fracture gap is clearly visible by this time.

So, I suggest you to go for a repeat xray of the injured part and also an MRI scan to rule out any ligamentous or any other soft tissue injuries.

If there is a fracture, the hand is to be immobilized in a plaster cast for 6-8 weeks.

Hope this information is helpful. Good day
Answered: Mon, 26 Aug 2013
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Orthopaedic Surgeon, Joint Replacement Dr. Saurabh Gupta's  Response
Feb 2014

If there is still tenderness(pain on pressure) in snuff box (area between and thumb) and weak grasp , it could be scaphoid fracture. Some time in initial xrays , fracture line is not visible and also require some more views of xray after clinical co-relation.
I suggest you to consult an orthopaedician nearby for a detailed examination. You may get repeat X-ray of the area affected under his/her guidance.
Answered: Mon, 26 Aug 2013
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