Overview
Fracture of the base of the thumb refers to a break in the metacarpal bone at the articulation with the trapezium 1. This injury commonly occurs in the context of thumb base osteoarthritis 1.Diagnosis
Diagnosis is typically made with plain radiographs of the thumb, including anteroposterior, lateral, and oblique views 1.
Further imaging such as CT may be considered for complex fractures or to assess articular involvement 1.Management
Non-surgical management is the mainstay for most thumb base fractures, particularly those that are non-displaced or minimally displaced 1.
Treatment options include immobilization with a thumb spica cast or splint for 4-6 weeks 1.
Pain management may involve oral analgesics 1.
Surgical intervention is reserved for significantly displaced fractures, intra-articular fractures with instability, or cases refractory to conservative management 1.Key Recommendations
Non-surgical management with immobilization is recommended for most thumb base fractures 1. (Evidence: Moderate)
Surgical intervention should be considered for unstable or significantly displaced thumb base fractures 1. (Evidence: Moderate)References
1 Gangopadhyay S, Jansen V, Sim Khor W, Gardiner MD, Burchette D, McKenna H. Guideline on managing thumb base osteoarthritis: The British Society for Surgery of the Hand Evidence for Surgical Treatment (BEST) findings and recommendations. The Journal of hand surgery, European volume 2025. link