[43F] With acute thumb injury and cardiovascular history

Patient Description

A 43-year-old female experienced a sudden thumb injury approximately 5 hours ago while pulling a nail, resulting in her arm slipping oddly from a hammer. The injury has led to swelling and some restriction of movement in the thumb, with a pain level of 4 out of 10. Both the wrist and thumb appear misshapen, and there is numbness present. The patient has not attempted any remedies or undergone imaging tests such as an X-ray. She has no history of previous injuries to the thumb or wrist. The patient consumes alcohol and tobacco daily. Her medical history includes a heart attack in June 2023, and she is currently on medications for cholesterol, blood pressure, and heart health, including baby aspirin (80 mg once daily), ramipril (once daily), atorvastatin, and apo-metoprolol (25 mg twice daily). She is allergic to penicillin.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

  • Sprain or Strain: This is a common injury that occurs when the ligaments (sprain) or muscles/tendons (strain) are stretched or torn. Given the sudden nature of your injury and the swelling, this could be a likely cause. Treatment typically involves rest, ice, compression, and elevation (RICE), along with over-the-counter pain relief.

  • Fracture: The misshapen appearance and numbness in your thumb and wrist could indicate a fracture. This occurs when there is a break in the bone, often due to a direct impact or fall. An X-ray is usually required to confirm a fracture, and treatment may involve immobilization with a splint or cast, and in some cases, surgery.

  • Dislocation: This occurs when the bones in a joint are forced out of their normal position. The misshapen appearance and numbness could suggest a dislocation. Treatment typically involves a healthcare professional repositioning the bones, followed by immobilization and rehabilitation.

What you can do

  1. Seek Medical Attention: It's important to see a healthcare provider as soon as possible to get a proper diagnosis and treatment plan. They may recommend an X-ray or other imaging tests to assess the injury.

  2. RICE Method: While waiting for medical attention, you can apply the RICE method:

    • Rest: Avoid using your thumb and wrist to prevent further injury.
    • Ice: Apply ice packs to reduce swelling and numb the area.
    • Compression: Use an elastic bandage to provide support and reduce swelling.
    • Elevation: Keep your hand elevated above heart level to minimize swelling.
  3. Pain Management: Over-the-counter pain relievers like acetaminophen or ibuprofen can help manage pain and reduce inflammation.

  4. Symptom Tracking: Use MDandMe to journal your symptoms, track your progress, and share this information with your healthcare provider.

What you should look out for

  • Increased Pain or Swelling: If your pain or swelling worsens, seek medical attention promptly.
  • Numbness or Tingling: Persistent numbness or tingling could indicate nerve involvement and should be evaluated by a healthcare professional.
  • Changes in Skin Color or Temperature: If your thumb or wrist becomes pale, cold, or blue, seek immediate medical care as this could indicate compromised blood flow.

Remember, while these suggestions can help manage your symptoms, it's crucial to consult with a healthcare professional for a formal diagnosis and appropriate treatment.

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1 mo ago


People Also Ask


What are the signs that a thumb injury might be a fracture rather than a sprain?

Signs that a thumb injury might be a fracture include a misshapen appearance, significant swelling, inability to move the thumb, and numbness. An X-ray is usually needed to confirm a fracture.


How can I manage pain and swelling at home before seeing a doctor?

To manage pain and swelling at home, you can use the RICE method: Rest the thumb, apply Ice packs, use Compression with an elastic bandage, and Elevate the hand above heart level. Over-the-counter pain relievers like acetaminophen or ibuprofen can also help.


Why is it important to seek medical attention for a thumb injury with numbness?

Numbness in a thumb injury could indicate nerve involvement or a more serious injury like a fracture or dislocation. Seeking medical attention is important to prevent long-term damage and ensure proper healing.


What should I do if I notice changes in skin color or temperature in my injured thumb?

If you notice changes in skin color or temperature, such as the thumb becoming pale, cold, or blue, it could indicate compromised blood flow. This requires immediate medical attention to prevent further complications.

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