A thumb contributes 50% to a person’s hand function. A thumb injury can potentially irreversibly damage the patient’s hand and therefore permanently affect life and ability to work.

1 week ago at ROC our schedulers got a call that a severely injured patient was coming. He was using a hammer and accidentally missed, impacting the tool into this thumb. Dr. Shuhatovich saw the patient emergently and immediately noted severe swelling, deformity and general discomfort of the patient, who was looking very distressed. Dr. Shuhatovich diagnosed the patient with a Rolando’s fracture and recommended immediate surgery to be done the same day.

A Rolando’s fracture is a fracture of a metacarpal bone of the thumb. The mechanism of the injury results in a shattered joint that allows the thumb to move. If not treated properly, this injury will result in lifelong disability and pain. The typical hand surgeon will put external pins in these fractures and put the patient in a cast. Months of healing will ensue, resulting in permanent disability, pain and stiffness. This pain is permanent and rarely responds to any therapeutic measures, including skilled hand therapy. A thumb with this amount of constant unrelenting pain will not allow the patient to grasp or lift anything with the injured hand.

The proper approach to Rolando’s fractures is open reduction and internal fixation. This procedure uses an internal plate and screws to realign the joint surface of the thumb and fix the bone fragments in such as way, that the patient will start motion immediately after surgery. With this approach the patient is back to full use of the hand by approximately 6 weeks. This will allow a potentially irreversibly injured patient to be back to work, play sports and enjoy hobbies.

This patient’s surgery went very well and a metal plate and 8 screws were used to stabilize a multitude of fragments of the patient’s thumb. The patient already started moving the thumb and will continue his rehabilitation to obtain full motion and grasp, so that he can get back to all his normal activities, life and work.