Broken Thumb (Child)

Home care

• The health care provider may prescribe medicines for pain. Follow the provider's directions for giving these medicines to your child. Don't give your child aspirin unless told to by the child’s provider.

• Keep the child's hand raised (elevated) to reduce pain and swelling. This is most important during the first 48 hours after injury. As often as possible, have the child sit or lie down and place pillows under the child’s arm until the hand is raised above the level of the heart. For babies and toddlers, lay the child down and place pillows under the arm until the injury is raised above the level of the heart. Make sure the pillows don't move near the face of the baby or toddler. Never leave the child unsupervised.

• Apply a cold pack to the injury to help control swelling. To make a cold pack, place ice cubes in a plastic bag that seals at the top. Wrap the bag in a thin towel. As the ice melts, be careful that the cast or splint doesn’t get wet. Don't place the ice directly on the skin. This can cause damage. You can place a cold pack directly over a splint or cast.

• Ice the injured area for up to 20 minutes every 1 to 2 hours the first day. Do this 3 to 4 times a day for the next 2 days, then as needed. To make an ice pack, put ice cubes in a plastic bag. Wrap the bag in a thin towel before putting it on your child's hand to prevent a skin injury. It may help to make a game of using the ice. But don't force your child to use the ice.

• Care for the splint or cast as you’ve been advised. Don’t put any powders or lotions inside the splint or cast. Keep your child from sticking objects into the splint or cast.

• Keep a splint or cast completely dry at all times. Cover the splint or cast with a plastic bag when your child bathes. Close the top end of the bag with tape or rubber bands. Keep the bag out of the water.

Follow-up care

Follow up with your child's provider as advised. Follow-up X-rays may be needed to see how the bone is healing. If your child was given a splint, it may be changed to a cast at the follow-up visit. If you were referred to a specialist, make that appointment right away.

Special note to parents

Providers are trained to recognize injuries like this one in young children as a sign of possible abuse. Several providers may ask questions about how your child was injured. providers must, by law, ask you these questions. This is done for the child's protection. Please try to be patient and not take offense.

When to contact your doctor

Contact your child's provider right away if:

• The splint or cast is wet or soft.

• The splint or cast is too tight. Loosen a splint before calling for help.

• Swelling or pain increases after a splint or cast is put on the hand. Babies not yet old enough to talk may show pain with crying that can't be soothed.

• The injured thumb, nearby fingers, or the hand are cold, blue, numb, burning, or tingly.

• Your child can’t move the fingers on the injured hand.

• There is redness, warmth, swelling, or drainage from the wound, or foul odor from the cast or splint.

• In babies, you see fussiness or crying that can't be soothed.

• Your child has a fever (see "Fever and children" below).

• Your child has chills.

Call 911

Call 911 if:

• Your child has trouble breathing.

• Your child has confusion.

• Your child has trouble waking up or is very drowsy.

• Your child faints or loses consciousness.

• Your child's heart rate is rapid.

• Your child has a seizure.

• Your child has a stiff neck.

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 months old, a rectal temperature is the most accurate.

• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the provider what type to use instead. When you talk with any provider about your child’s fever, tell them which type you used.

Below are guidelines to know if your young child has a fever. Your child’s provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

• First, ask your child’s provider how you should take the temperature.

• Rectal or forehead: 100.4°F (38°C) or higher

• Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

• Rectal, forehead, or ear: 102°F (38.9°C) or higher

• Armpit: 101°F (38.3°C) or higher

Call the provider in these cases:

• Repeated temperature of 104°F (40°C) or higher in a child of any age

• Fever of 100.4° (38°C) or higher in baby younger than 3 months

• Fever that lasts more than 24 hours in a child under age 2

• Fever that lasts for 3 days in a child age 2 or older