Dislocating thumb

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Dislocating thumb

Postby Guest » Thu Nov 03, 2005 1:11 am

Hi, I'm new to this site but was hoping someone might be able to help me out with some information or advice?

I'm struggling at the moment with one of my thumbs - it keeps dislocating. The first time was during childbirth (yes....bizzare labour related injury!) four months ago. At the time I didn't feel anything due to the pain relief and for the following weeks I suffered with pain and swelling in my wrist. My doctor told me it was tendonitis and after taking anti-inflammatories the swelling reduced, leaving me with a thumb that 'pops' in and out. A second visit to the doctor resulted in him telling me it was dislocating and was linked to my hypermobility (diagnosed 15 years ago in my teens) and he sent me for X-rays. These showed that no long term damage was being done by this and that there were no fractures. His response was that basically there is nothing that can be done to help me and that I shouldn't strap my hand in any way as this will reduce the strength in the joint.

I wasn't particularly happy with this and went to see a physio who gave me pilates exercises for my thumb and recommended a thumb spica for when it's particularly bad or for when I know I'll be doing something that'll make it hurt. He wasn't optimistic about the success of these exercises as he said that the tendons will all now be overstretched and there's no way to tighten them with exercise, I can only try and strengthen the muscles in my thumb.

So I'm left with a thumb that dislocates outwards when I move my hand in the slightest way - gesturing whilst talking, turning over during the night, holding a mug, not to mention dealing with an active 4 month old baby! It's really painful and I'm at a bit of a loss as to what to do. The physio said it's an orthopaedia specialist next but I'll have to go back through my GP for a referral....

Any hints or tips??
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Postby Mari » Thu Nov 03, 2005 1:46 am

Hello,

My nephew's thumbs dislocate when he writes. He uses thumb splints, which were made for him by an Occupational therapist. You could use them only when doing something particularly physical, e.g. I use my wrist splints for driving, lifting, etc. As long as you don't wear them all the time, perhaps that would be fine?

Mari
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Postby nonyanomemory » Thu Nov 03, 2005 1:51 am

Hi and Welcome to the hmsa, :) . Here you will find us a friendly bunch of people. Congratulations on the birth of new baby also.

Have you thought about having a occupational therapists assessment at all for the home to see if there is anything they can provide to help with everyday management. There is info on home page of the site which gives hints and tips about some gadgets etc that help and a database for useful links. I am a bit lazy and forget to go there but its certainly worth a good look. i am suppossed to wear splints for ALL functional use with my hands to prevent ongoing injury and dislocation, but find them very restrictive and have problems with chafing and thin skin so it is a little problematical.

It may be also that your hormones are raging after the birth of baby and when these settle a little you may find your thumb does too. I know after the birth of both of mine (they are teenagers) I was really really bendy. I am not a fan of surgery and unless the surgeon really understands the condition it is something that really needs thinking about.

I am afraid I'm a little tired as it is late but I will try to think of any tips over the next few days. In the meantime..... try as much as possible to look at the way you approach tasks and see if you could change the way you do somethings. For example - silly things like taps - do you have tap turners or easy use ones fitted. Are you carrying stuff for the baby (let alone the baby!) which could be put on a trolley rather than carried, even washing etc.

I will pm Alison our lovely resident Occupational Therapist who also has hypermobility if she can answer your post with helpful ideas. In the meantime - take care and peeps :help: please this lady needs ideas :idea:

nonya
46yr female EDS H/mobility Type c/over vascular Dxd Prf G
V Prem club ft short stature early onset varicose veins thin skin
Striae o'rthritis/porosis PHN POTS spasms n'pathic pn IBS bladder stuff bulging discs & more!

d/tr severe EDS 20 yr
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Postby Guest » Thu Nov 03, 2005 9:29 am

I hadn't thought about the hormones - that could well be making it worse. Yet another after effect that you don't realise about!

The strange thing is that it doesn't dislocate when I'd expect it to - like when I open a jar or lift the baby or something. It just seems that I have to catch it in just the wrong place and I can be doing something that puts no pressure on the joint at all.

I do have some gadgets already to help me out as I have Raynauds as well, which makes me very clumsy and means that I can't drip anything properly, particularly during the winter and does affect my hands quite badly. I'll have a look at the info you suggested as well though.

Thanks for your posts, this is getting to me a bit now and the party-trick novelty has most definitely worn off!
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Postby Blunderwoman » Fri Nov 04, 2005 12:15 pm

Hi - welcome to the boards.

My 14 year old daughter Hannah has problems with her right thumb which first dislocated in June this year. Usually she can sort out her finger dislocations herself but this time we had to go to A&E and she was given gas and air to have it put back. It was sticking out at a very odd angle and much lower down than where it should be but oddly, did not show up on the XRay. Anyway, it was put back and she was put in plaster for a week. When the plaster came off we only went a few weeks before it did it again. Another A&E visit, another useless XRay, more gas an air and another plaster cast. When this cast came off it did it again, and again. They tried a splint instead of a cast but her thumb just came out in the splint. One time they had to put it back three times before they could get a cast on. She has been in plaster now for months and, just to make things worse, the left thumb has gone twice now as well. Her doctor took her in to hospital a couple of weeks ago, for the day, and gave her a general anaesthetic so that he could dislocate her thumb to see what was happening. He found that she dislocates the opposite way to normal, cant remember which way round but if outwards is the normal way, she dislocates inwards or vice versa. She is waiting to have surgery where a tendon will be taken from her wrist and wrapped around the joint to try to hold it in place. If this doesnt work then the only option will be to fuse the joint which will restrict movement in her thumb. I know that surgery is the last resort but she cannot go on the way she has been, without a cast her thumb will not stay in place and the local hospital will not touch her if she dislocates, meaning a trip of 20 miles each way to the General hospital each time to have it put back.

I dont want to scare you and I hope that things may settle down when your hormones settle but I wanted to let you know of our experience.

Take care

Pauline
Blunderwoman
 

Postby Guest » Sat Nov 05, 2005 12:51 am

Thanks for the info. It sounds like she's having a really rough time - I hope things don't end up too drastic.

I've also found that some nurses are unwilling to touch a dislocation - got sent round the houses also when I needed help a few weeks ago until they finally found a trauma nurse who was prepared to do some strapping up. Seems like people are frightenend of doing the wrong thing while helping you....which in turn isn't a real help!

I'm contemplating going back to my GP as I woke up at least half a dozen times last night with the pain from it dislocating. And one of the times I struggled to get my thumb back into place which was really painful. I don't know whether I should wear the thumb spica for a couple of days just to maybe give it some time to hopefully heal a little or whether that will just make it worse....
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Postby nonyanomemory » Sat Nov 05, 2005 1:08 am

Hi, check with your therapist but it may be that wearing a night splint if appropriate to stop this happening in your sleep may help or the one you have already provided. A phone call may suffice. Bizarrely, both Hannah and you for different reasons are going through hormonal 'stuff' and it seems at these times we are so prone to these problems. I do so hope it settles down. I do think referral to a hospital OT may be beneficial to you as it must be very difficult dealing with this with such a young baby. I'm sorry not to be more helpful here but I do understand. At a recent visit to University College Hospital the physio there suggested that I try wearing hospital type latex gloves as long as you have no allergy (something I know has been suggested also by Professor Bird in Leeds for other hypermobiles) Unfortunately for me it had them all laughing as they couldn't find any small enough and I just ended up looking for like a wrinkled chicken! However it is felt that the type of support they give (despite the fact that they look so awful :cry: ) helps improve things. It may be worth even keeping a box of these handy when changing the baby's nappy etc to see if it helps at all. I know it sounds really bizarre but apparently it helps. You must be feeling tired waking up so many times with this at night so anything that helps you get a good nights sleep whether it be from night splints etc is worth a go. Take care nonya
46yr female EDS H/mobility Type c/over vascular Dxd Prf G
V Prem club ft short stature early onset varicose veins thin skin
Striae o'rthritis/porosis PHN POTS spasms n'pathic pn IBS bladder stuff bulging discs & more!

d/tr severe EDS 20 yr
nonyanomemory
Carpal tunnel
 
Posts: 1066
Joined: Tue Aug 17, 2004 9:55 am
Location: uk

Postby Retro » Sat Nov 05, 2005 1:24 pm

If you are allergic to latex the coloured gloves they use in hospital are nitrile gloves but I don't know if they'd have the same supportive properties as latex.
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Postby Guest » Mon Nov 14, 2005 6:24 pm

Hi welcome to the forums.

I was the one Prof Bird suggested latex gloves to, I tried them and besides smelling like err balloons :lol: they was no use at all.

Last year I feel onto my thumb and bent it three ways before I came to a stop (Amazing what a hypermobile body can achieve :lol: ) after nearly a week of not managing to move my hand correctly I was beginning to think I had broken my Scaphoid (For the 4th time in my life :roll: ) so went to hospital) after a lot of messing around they referred me there and then to a plastic surgeon who was very shocked at how hypermobile my hands were especially my thumbs and said if I had further problems with my thumbs after that day to see her and she would suggest the operation that Pauline’s daughters been recommended and I was told it is a far better option than a fusion as it will not cause the domino affect.
For now however I am coping with splints and taping, as I want any surgery to be the final answer. The night splints Nonya suggested can also be used as rest splints, though rest is maybe a dream when you have just had a child :lol:
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Postby Blunderwoman » Wed Nov 16, 2005 10:30 am

Hi Azazel

In your post you mention a "domino affect" after a fusion operation. Can I please ask what this means. Hannah's doctor has said that if she has to have a fusion operation it will limit the movement she will have in her thumb, is this the same thing? If this first op doesnt work then he says it will have to be fusion so it would be handy to know all the "ins and outs" in advance.

Thanks

Take care

Pauline
Blunderwoman
 

Postby Guest » Wed Nov 16, 2005 4:19 pm

Sorry Pauline I get so used to saying things I sometimes miss the explanation.
If you fuse a joint in a hypermobile or EDS person it will eventually put strain on the surrounding joints and weaken them until they sublux as much as the one that is fused until they too need fusing. This of course is like a domino effect (or pack of cards falling down whichever picture you want to use). Which is why fusing’s of the joints should be the ultimate last resort. The wrapping around of a tendon is a choice and one that was suggested to me, but not until I got to the stage your daughter is at and mine are far from at that point.
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Postby nonyanomemory » Wed Nov 16, 2005 5:42 pm

Hi Az, thought you'd pick up on the latex gloves :wink: It was also suggested to me a few weeks ago at UCL hypermobility clinic London. They have heard of the latex glove theory their as well :whip: (sorry peeps old joke :lol: ) Despite the jokes - with a wriggling baby at nappy change it may well work. Oh fingers and thumbs who'd think they could be so troublesome - I guess only us lot :bye: nonya
46yr female EDS H/mobility Type c/over vascular Dxd Prf G
V Prem club ft short stature early onset varicose veins thin skin
Striae o'rthritis/porosis PHN POTS spasms n'pathic pn IBS bladder stuff bulging discs & more!

d/tr severe EDS 20 yr
nonyanomemory
Carpal tunnel
 
Posts: 1066
Joined: Tue Aug 17, 2004 9:55 am
Location: uk

Postby Guest » Wed Nov 16, 2005 5:51 pm

I'm staying :shh: for a change Nonya
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Thanks and an update

Postby Guest » Tue Sep 12, 2006 9:07 pm

I just wanted to thank you all for your help and suggestions and I thought I'd let you know an update.

At about six/seven months postnatal - just as I'd got my appointment to see the ortho specialist - my thumb stopped dislocating. Just over night there was suddenly no problem at all.

The assumption from my GP is that it was all related to pregnancy hormone levels. My son is now 14 months old (and heavy!) and although my thumb aches sometimes from carrying him, I'm really lucky that this has sorted itself out.

Anyway, I just wanted to say thanks for the support you gave me. It really meant a lot and made me feel like I wasn't going round the twist! I hope everyone is doing well.

Thanks again. x
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Postby nonyanomemory » Tue Sep 12, 2006 10:37 pm

Thanks for the update and glad to hear the thumb has improved. 14th months - good grief time does fly by :!: take care - nonya
46yr female EDS H/mobility Type c/over vascular Dxd Prf G
V Prem club ft short stature early onset varicose veins thin skin
Striae o'rthritis/porosis PHN POTS spasms n'pathic pn IBS bladder stuff bulging discs & more!

d/tr severe EDS 20 yr
nonyanomemory
Carpal tunnel
 
Posts: 1066
Joined: Tue Aug 17, 2004 9:55 am
Location: uk

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