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Most thumb sprains are from falling on an outstretched hand such as skiing or snow boarding. Most routine sprains are mild and respond to hand based splinting within 4-6 weeks. More severe sprains after 4 weeks tend to show no improvement. All of these injuries need an early x-ray to rule out a fracture. More severe sprains often need surgical attention as symptoms persist despite bracing.
Compartment syndrome is a highly dreadful complication, which may occur from 1-3 days after application of a thumb spica cast. It occurs due to inability of the thumb spica cast to accommodate the hand swelling. The pressure of the swelling on the blood vessels and nerves cuts down the blood supply and sensations of the hand. Prompt removal of the cast is necessary to prevent permanent damage to the hand. Hence, a thumb spica cast should not cover the tip of the thumb, which can be observed for checking the integrity of the blood flow to the thumb. Picture 1: Thumb Spica Cast (Source: Queenâs University School of Medicine) Thumb Spica Splint