Orthopedics-Online

Capsule tear on the thumb

What is a capsule tear on the thumb?

The joints that connect the individual bony elements of the thumb are each surrounded by a capsule made of connective tissue, which stabilizes it and enables smooth movements.

Using force can tear the thumb capsule.
The consequences are pain and limited mobility.

As a rule, the treatment is primarily carried out by protecting and resting the thumb.
Surgery is only required under certain circumstances.

In most cases, a capsule tear on the thumb heals without any consequential damage. Sometimes, however, there is also a long-term limitation of the function of the hand.

treatment

The immediate treatment after a capsule rupture on the thumb consists of immobilizing the hand and cooling it (for example with an ice pack that is wrapped in a kitchen towel).

A doctor should then be consulted as soon as possible, who, depending on the findings and the diagnosis, specifies the further course of action regarding the therapy.
In most cases, no special treatment is required and the capsule tear on the thumb must heal for the next few weeks through rest and immobilization.

If necessary, the doctor prescribes a special splint or he tapes the affected joint.
Only in a few cases does the severity of the injury require direct special treatment:

If the thumb is dislocated, it must be adjusted as soon as possible.
If there is an injury to bone or vision, surgical treatment is usually unavoidable to repair the damage.
In addition, with all forms of the capsule rupture on the thumb, the temporary intake of an anti-inflammatory pain reliever may be appropriate.

How do you wallpaper a cracked capsule on your thumb?

If the capsule tears on the thumb, professional taping can stabilize and distribute the force on the injured finger.

Precise knowledge of the anatomy and the movement functions of the thumb as well as experience are necessary to achieve the desired effect.
Therefore taping should only be carried out by a trained person.

Although there are numerous instructions on how to do it yourself on the Internet, it is advisable to see a doctor first if the capsule ruptures.
Among other things, the doctor should rule out whether there is an injury that should be treated by surgery.

In addition, taping is a good, but not always the most suitable form of immobilization in many cases.
The mobility of the thumb is relatively little restricted.
In some cases, the prescription of a splint or orthosis, which gives the thumb more stability, is therefore necessary.

Please also read the section: Taping a capsule tear

rail

In some cases, the doctor will prescribe a splint if the thumb capsule tears.
A special form is the so-called Quengel splint, which exerts pressure on the joint using spring wire clamps and thus counteracts restricted mobility.

In this way, permanent stiffening of the affected joint is to be avoided.
In the event of a torn capsule on the thumb with a high degree of instability, a rigid splint can temporarily be used to completely immobilize.

Such splints are therefore often used even after an operation.

Bandage / orthosis

A bandage is a treatment option for immobilizing a capsule on the thumb.

In contrast to a splint, mobility is less restricted, so a bandage is an option for less pronounced injuries while maintaining stability in the joint.
It is usually a stocking-like cover made of an elastic material that fits tightly to the thumb.

In addition, a bandage can also be applied with elastic wraps, whereby the tension must be strong enough to ensure stability, but the bandage must not be too tight either.

Read more on this topic at: Thumb brace

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I would be happy to advise you!

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When is an operation necessary?

In most cases, a capsule tear on the thumb heals completely by taking care of the affected joint and temporarily immobilizing it.

However, surgery is required if structures have been injured that will no longer heal without intervention or if the affected joint is very unstable.
Often one needs an operation for larger bony capsular ligament tears, as otherwise the joint wear and a significant functional impairment of the hand can occur prematurely.
Even if ligaments or tendons are torn, a promising treatment can often only be carried out through an operation.
Even if there is a dislocation that cannot be remedied by any other means, surgery can be the only remaining treatment method.

Duration of healing

The duration of healing after a capsule tear on the thumb depends on the one hand on the extent of the causal injury and on the other hand on the affected structures.

A simple capsule injury can heal completely within a few weeks.

However, if bony structures were also injured and an operation had to be performed, a healing period of at least six weeks can be expected.

Healing takes a particularly long time when tendons have been injured and they have to grow back together. A duration of up to twelve weeks can be expected.

However, it must be borne in mind that the healing time for a capsule rupture on the thumb can vary greatly from person to person and also depends on the age and activity of the person affected.

Please also read the article: Tendon tear on the finger

How long have I been unable to work?

The duration of the inability to work in the event of a capsule tear on the thumb depends on the one hand on the extent of the injury and the duration of healing and on the other hand on the activity performed.
Anyone who is very dependent on the function of the thumb in their work is consequently unable to work longer than someone who can compensate for the consequences of the injury.

In the case of only minor injuries and the corresponding activity, the doctor can therefore also decide that there is no incapacity for work at all.
In some cases, however, you have to be on sick leave for weeks or even months due to a ruptured thumb capsule.

What late effects can occur?

In most cases, a joint capsule injury on the thumb heals without any long-term effects.

Long-term restrictions are only to be feared in complicated cases involving tendons, ligaments or bones:

For example, in about one out of five cases of a capsule tear on the thumb with a simultaneous flexion injury, the hand remains less mobile.
Another possible long-term consequence of joint injuries can generally be premature wear (med.
The risk of this is increased especially in the case of torn ligaments in the context of the capsular tear on the thumb.
You can also read our topic: Bone splintering on the thumb

Concomitant symptoms

When a capsule rupture occurs on the thumb, in most cases this is manifested by:

sudden severe pain.
In addition, the affected joint usually swells within a short time.
The mobility is suspended or at least severely restricted.
If a blood vessel was also damaged in the injury, a bruise (bruise) may also form.
Another accompanying symptom of a particularly severe injury with extensive rupture of the capsule on the thumb is often additionally dislocated or in an unnatural position.
If nerve tracts are irritated, additional symptoms such as tingling or numbness can occur.

Pain after a capsule tear on the thumb

Pain when the capsule ruptures on the thumb is usually the main symptom of such an injury.

As a rule, immediately after the causal event, such as a bouncing ball during sports, a sharp, bright pain sets in.
After a few minutes, the character turns more into throbbing, dull pain.
Typically, the pain is aggravated when attempting to move the thumb.
In addition, pain triggered by slight lateral pressure on the affected joint indicates a capsule tear on the thumb.

If necessary, the symptom can be combated by taking a pain reliever medication and cooling.

Find out more about this topic at: Painkiller

swelling

Normally, a healthy joint capsule provides a balance between the production and removal of synovial fluid for the amount of synovial fluid required for joint function.

If the capsule ruptures on the thumb, synovial fluid escapes, is deposited in the surrounding tissue and cannot be removed there immediately.
The result is a swelling that forms soon after the triggering event.

In addition, the body's own defense system reacts with an inflammatory reaction to the damage caused by a capsule rupture on the thumb. This leads to increased blood flow and additional storage of fluid due to the widening of the smallest blood vessels.

The swelling in the case of a capsule injury can be counteracted to a certain extent by cooling.

Bone chipping

In the context of a capsular rupture on the thumb, an accompanying injury can lead to a fragment of bone at the affected joint.

These injuries occur when the capsule itself or a ligament together with a splinter is torn out of the bony anchorage.

Involvement of bony structures in a capsule rupture on the thumb can usually be recognized by an X-ray of the hand, so that this examination should be carried out if the doctor suspects this.

A chipped bone usually cannot heal by itself but has to be remedied by an operative intervention.
The loosened part of the bone is fixed back in its original position, for example with a small wire.

Read many more topics under our topic: Bone chipping

diagnosis

As a first step in diagnosing a torn capsule on the thumb, the doctor must answer a few questions.
Among other things, he will want to know how the injury came about and what symptoms are present.

The affected thumb is then examined.
The examiner looks at the joints and looks for swellings and misalignments.

In addition, he will feel carefully, check the stability and, if necessary, test the active and passive mobility.
If the doctor suspects an injury to bony parts, he will order an X-ray examination of the hand to prove or exclude it.

A sprain pain is typical of a broken bone.
Further examinations such as an MRI should be reserved for justified exceptional cases.

MRI of the hand

Magnetic resonance imaging (MRI) of the hand is a very costly and time-consuming form of examination that is usually not indicated in the case of a capsule rupture on the thumb.

The diagnosis can usually already be made based on the physical examination and the medical consultation.
In most cases treatment with rest and immobilization is used and performing the MRI would have no effect on the treatment of the patient.

Only in a few cases is it advisable to perform an MRI of the hand. For example, if an injury is suspected that may need surgery, the MRI result can influence the decision for or against an intervention.

You might also be interested in:

MRI of the hand
and
Procedure of an MRI

causes

In most cases, a capsule rupture on the thumb occurs due to violent hyperextension.
This in turn can have various causes.

Such an injury often occurs in the course of sporting activity, with handball or volleyball in particular being associated with a high risk. If a ball hits the outstretched thumb, it can injure the joint capsule.

When skiing, getting stuck in a loop of the ski pole typically leads to a capsule tear in the thumb, which is why such a case is also referred to as a “skier's thumb”.

In addition to sporting activity, everyday activities can easily injure the joint capsule.
In particular, a fall on the thumb can cause damage.