Imaging Case of the Week 38

This thumb x-ray is from a 15 year old patient who fell on his outstretched hand and sustained an injury to his left thumb. What can you see ?

 xray 1

click to enlarge

xray 2

click to enlarge

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The x-ray shows avulsion fracture of the base of the medial aspect of proximal phalanx of the thumb.

Avulsion fracture

This fracture is associated with an injury to the attachment of ulnar collateral ligament of the thumb MCP joint, thereby causing instability at the joint (Gamekeeper’s thumb).

The treatment for this injury is thumb spica and a referral to a hand surgeon.