An orthopedist will look at your x-rays and other tests to help determine the best treatment option. He will take into account the type of fracture (intra- or extra-articular), as well as the complexity (Bennett's versus Rolando’s fractures). In relatively straightforward cases (such as an extra-articular fracture) the doctor may be able to replace the fracture fragments manually without surgery. She will provide anesthesia before attempting to realign the fragments.  This method (also referred to as a closed reduction) typically consists of the doctor pulling and tugging along the break to realign it while using a fluoroscopy (continuous, realtime x-raying) to see when the fragments are realigned.  Note that some Rolando’s fractures, especially those where the bones are shattered into too many pieces to screw or pin together, may also be treated in this method with the surgeon molding the fragments to the best of his ability (known as an open reduction). For intra-articular fractures (such as Bennett's and Rolando’s fractures), your orthopedist will usually suggest surgery. The specific type of surgery will depend on the complexity of the fracture(s). Typical options include:  Using fluoroscopy to place wires through the skin to realign the fragments, known as external fixation. This option typically pertains to Bennett's fractures where the fragments have remained very close together. Having a surgeon open the hand to place small screws or pins into the bones in order to keep them properly aligned. This is known as internal fixation. Potential complications from surgical options include nerve or ligament injuries, stiffness, and increased risk of arthritis. Whether your particular case calls for a surgical or non-surgical option, the doctor will place your thumb in a spica cast to immobilize it and keep all of the fragments perfectly in place during the recovery period.  Expect to wear the cast anywhere from two to six weeks, with closer to six being the norm.  Your doctor may also schedule follow-up appointments during this time. Depending on the length of time you spend in the cast and your mobility upon the removal of the cast, your doctor may recommend that you see a physical or occupational therapist. A therapist will be able to provide a number of flex and grip exercises to rebuild strength due to atrophied muscle during the immobilization period.
قم بمقابلة جرّاح عظام. اسأل الطبيب عن التدخّلات غير الجراحية. فكّر بالتدخّل الجراحي. ثبّت الإبهام. قم بزيارة طبيب علاج طبيعي.