Thumb Pain After an Accident: Skin Injury vs. Bone Fracture

After the car accident, the side of the thumb has a layer of skin peeled off and there is a bruise?

Accidentally pressing the accelerator while moving the car caused the skin on the side of my big toe to peel, and there is a bruise with a blood clot.
It has been two days, and my big toe continues to have a dull ache.
Could the pain be due to a possible fracture or is it caused by the wound?

AMenda, 30~39 year old female. Ask Date: 2023/01/21

Dr. Li Zhonghuai reply Surgery

Hello! If you have been compressed or injured, it's safer to go to the hospital for an X-ray.
Take care! Changhua Hospital cares about you!

Reply Date: 2023/01/21

More Info

When dealing with thumb pain after an accident, particularly one involving skin injury and potential bruising, it is essential to differentiate between pain caused by soft tissue damage and pain resulting from a possible bone fracture. In your case, the fact that you have experienced skin abrasion and bruising, along with the presence of a blood clot, suggests that there has been significant trauma to the area.

Understanding the Pain
1. Soft Tissue Injury: The skin injury you described, including the peeling and bruising, can lead to localized pain due to inflammation and swelling. When the skin is damaged, the underlying tissues, including muscles, tendons, and nerves, can also be affected. This can result in pain that may feel sharp or throbbing, especially when you move your thumb or apply pressure to the area.

2. Bone Fracture: On the other hand, if there is a fracture in the bone, the pain is often more severe and can be accompanied by swelling, bruising, and difficulty moving the affected digit. Fractures can sometimes be subtle, especially in small bones like those in the thumb, and may not always be visible on initial examination. Symptoms of a fracture can include:
- Intense pain that worsens with movement or pressure.

- Swelling and bruising around the injury site.

- Decreased range of motion or inability to use the thumb normally.

Recommended Actions
Given that it has been two days since the injury, and you are still experiencing pain, it is advisable to take the following steps:
1. Rest and Immobilization: Avoid using the thumb as much as possible. You might consider using a splint or buddy taping the injured thumb to the adjacent finger to immobilize it and reduce movement, which can exacerbate pain.

2. Ice Therapy: Apply ice to the injured area for 15-20 minutes every hour as needed. This can help reduce swelling and numb the pain. Make sure to wrap the ice in a cloth to avoid direct contact with the skin.

3. Pain Management: Over-the-counter pain relievers such as acetaminophen or ibuprofen can help manage pain and reduce inflammation. Be sure to follow the recommended dosage on the packaging.

4. Observation: Monitor the injury for any changes. If the pain worsens, if you notice increased swelling, or if you develop new symptoms (such as numbness or tingling), it is crucial to seek medical attention.

5. Medical Evaluation: If the pain persists beyond a few days or if you suspect a fracture, it is essential to consult a healthcare professional. They may recommend imaging studies, such as an X-ray, to rule out any fractures or other underlying issues.

Conclusion
In summary, the pain you are experiencing in your thumb could be due to either soft tissue injury or a bone fracture. Given the trauma involved, it is prudent to take measures to rest and protect the thumb while monitoring your symptoms. If there is no improvement or if the pain intensifies, seeking medical evaluation is the best course of action to ensure proper diagnosis and treatment. Remember, early intervention can often lead to better outcomes, especially in cases of fractures or significant injuries.

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