Fracture of the ulnar sesamoid of the first metacarpophalangeal joint
Diagnosis certain
Presentation
1 day of swelling and pain about the base of the right thumb post-traumatic abduction of the digit.
Patient Data
Age: 13 years
Gender: Male
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Fracture of the ulnar sesamoid of the MCPJ of the thumb.
Case Discussion
Fracture of the pollex sesamoid is rare, and an often missed diagnosis.
Patel et al (1990) classified sesamoid fracture of the metacarpophalangeal joint of the thumb into two types:
- Type 1: With the volar plate intact the patient maintains the ability to flex the MCPJ and IPJ 2.
- Type 2: With the volar plate ruptured the patient's thumb assumes a hyperextended posture and they are unable to flex the MCPJ 2.
When there is no joint instability, immobilization for a period of two weeks is usually sufficient management 1.
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