Potential Surgical Intervention for First Metacarpal Fracture
Are you wondering if surgery might be necessary for this type of fracture? I am a 37-year-old female weighing 116 pounds, and I sustained an injury to my thumb when it got caught in the steering wheel while I was backing up a side-by-side vehicle that jolted as I was loading it onto a trailer. I have a history that suggests I might have Ehlers-Danlos Syndrome (EDS) or hypermobile EDS (hEDS), and this is the first time I've injured my thumb. Back in late September, I suffered a thumb injury involving the steering wheel. After my initial x-rays and an MRI were conducted, the diagnosis reported a “grade 2 sprain affecting both the front and back of my thumb.” I did mention that I felt pain at the base of my thumb as well, but they seemed to overlook that area in subsequent evaluations. We have been in a holding pattern, but my injury hasn’t improved. Given my suspicion of having EDS, I asked if this could contribute to my issues, and the doctor agreed that it was worth investigating further, which led to a referral to a rheumatologist. Recently, as per the rheumatologist's advisement, I underwent another MRI for my wrist after the x-ray revealed some concerns. The results indicated a “displaced intra-articular fracture at the base of the first metacarpal, along with poorly defined bone edema, a small amount of joint fluid accumulation, and indistinct inflammatory changes around the joint.” Considering that significant time has passed and I have been using a basic splint about 70% of the time, do you think surgery could be necessary? I won't have my next appointment for another two weeks. Thank you in advance for your insights!
Answers (1)
3/19/2025, 12:50:38 AM
OpenHealth AI
It sounds like you are dealing with a complex situation regarding your thumb injury, and your concerns about the need for surgical intervention are valid, especially given the nature of your fracture and your possible Ehlers-Danlos Syndrome (EDS).
Overview
You have a displaced intra-articular fracture at the base of your first metacarpal, which can be concerning due to its potential impact on thumb function. Given that you have not seen improvement over time and the current imaging shows specific complications, it’s understandable to wonder if surgery might be necessary.
Explanation
- Displaced Intra-Articular Fracture: This type of fracture can disrupt the smooth surface of the joint and lead to complications like chronic pain, stiffness, and arthritis if not treated appropriately.
- EDS Consideration: If you have EDS or hypermobile EDS, your ligaments and connective tissues might be more lax, potentially complicating healing and recovery from injuries.
- Time Factor: When injuries are significant and recovery stalls after a prolonged period, surgical intervention may be needed to realign bones and stabilize the structure for proper healing.
Next Steps
- Monitor Symptoms: Keep a close watch on any changes in pain levels, mobility, or swelling in your thumb and wrist.
- Continue Splinting: Keep using the splint as advised; it can help stabilize the area and prevent further injury.
- Pain Management: Use over-the-counter pain relievers, such as ibuprofen or acetaminophen, to manage pain and inflammation if you aren’t already doing so.
- Prepare for Your Appointment: Make a detailed list of symptoms, activities that worsen your pain, or any changes you've noticed since the last evaluation. Having this information ready can help in discussions about surgical options with your doctor.
- Discuss Surgical Options: At your upcoming appointment, discuss the possibility of surgical intervention directly with your doctor. They can provide clarity on the risks and benefits given your specific situation and your EDS history.
It’s normal to feel anxious while waiting to fully understand your treatment options, but being proactive in monitoring your condition and preparing for your discussions with your healthcare team will empower you in this process. Make sure to express all your concerns and preferences during your next appointment.
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