I was delighted to hear a story about my cousin’s daughter Eva referring to her thumb as her “mate”. Her grandpa had taught her to do a ‘thumbs up’ and explained to her that you can say “g’day mate!” when you give someone the thumbs up. She logically assumed therefore that this particular appendage was called “mate”. One day she came running up to her mum yelling, “I hurt my mate!”, holding her thumb which she had just injured. Bless!
I saw a 12 year-old girl who had injured her left thumb at school – she was reaching out to pick up a ball when another student went to kick the ball, instead kicking her thumb! She heard and felt a crack and it was immediately painful and swollen.
On examination she had a swollen, slightly bruised left thumb with tenderness mainly over the palmar and lateral aspects of the base of the thumb. Her range of movement was restricted mostly in extension and abduction due to the pain.
I sent her for an X-ray of the left thumb after placing her in a splint and she returned later that day with the following images (apologies for the poor quality cut-off pictures taken with my iPhone!)
Although I am in the country, with the help of my trusty iPhone these days I can easily send a text to the plastics or orthopaedics registrar so that they can see the X-rays first hand and give accurate advice over the phone. They advised a full below-elbow thumb spica in a neutral position and I sent her on her way to be seen in outpatients in a few days’ time.
As it turns out, this 12-year-old had a couple of incidental endochondromas, which had been completely asymptomatic. She is due to go back to the hospital for x-rays of other regions to check for more of these, which can occur in a condition called Ollier’s disease. The avulsion at the base of the proximal phalanx of the thumb was far less interesting and attracted much less attention in the X-ray report and the consulting room!