Thumb Metacarpal Base Fracture

A 13-year-old boy presents with an acute sport-related thumb injury. Radiographs demonstrate a minimally displaced intra-articular fracture at the base of the first metacarpal. He was treated nonoperatively with thumb spica cast immobilization for 1 month. At that time, he was noted to be asymptomatic and he was allowed to return to full activities.A 14-year-old girl also presents with an acute sport-related thumb injury. Radiographs demonstrate an extra-articular fracture at the base of the first metacarpal. She was initially splinted. However, she was noted subsequently to have angulation of her fracture. She underwent closed reduction and percutaneous pinning. The pins were removed after 4 weeks. She returned to full activity at 7 weeks.