Hand Surgeon Questions Hand Injuries and Disorders

My son jammed his thumb while playing tennis. Could there be a permanent damage?

My son jammed his thumb while playing tennis. We got a X-ray that indicated no fracture. However the thumb is swollen and is causing a lot of pain. Could there be any permanent damage? Should he be doing any exercises or avoiding them?

9 Answers

A sprained thumb can last a few weeks. If he feels comfortable, he should try and move it, but don’t do anything strenuous. If he still has significant pain after 4 weeks, he should be re-evaluated.
It is important to always seek a medical evaluation by a licensed professional to ensure it is not the manifestation of something more serious. You also want to seek help sooner rather than later to prevent any further damage to the area.
Thumbs can have joint ligament injuries that can be serious and need surgery. In these situations, the X-rays can still be normal. Your son should see a hand surgeon to have an exam of the ligament stability of the thumb!
Yes, this is possible. There may be damage to the cartilage of the joint that would not be detectable by x-ray. Without any additional information, it would be impossible to comment on the second question.
The thumb should be examined by someone with good knowledge regarding these injuries, preferably a hand surgeon or a hand therapist. It is possible that there may be permanent or irreversible damage even in the absence of a fracture. Examination of the thumb is necessary to rule out other possible injuries.
It is possible that he may have injured a ligament which stabilizes the thumb joint. This is a common injury. I would recommend you take him to see a physician if he is not getting better.
It is critical that your son be evaluated by a hand surgeon, as there can be severe injuries to the soft tissue such as an ulnar or radial collateral ligament injury that may require immobilization or sometimes surgery. Often, a good clinical exam and stress exam is helpful. On occasion, an MRI to evaluate the soft tissue is indicated. If he is still having pain, please have him evaluated. Check for a local hand surgeon at ASSH.org.
A common injury is a thumb ligament injury that may have a normal X-ray. A younger child with open growth plates can have a fracture in the growth plate that may not be obvious. Sometimes a "jammed" joint with no complete ligament injury or no fracture can still hurt for many months.
If it’s not better within a few days, he should be evaluated by a hand surgeon. Just because there is no fracture, doesn’t always mean a simple sprain. Further evaluation may be required.

Harrison Solomon, M.D.