Fracture of the base of the first metacarpal bone

　　The fracture of the base of the first metacarpal bone is a common fracture of the hand, and its etiology is mainly trauma. In the elbow, the ulnar nerve can be injured directly or as a combined injury with fracture and dislocation; if the arm is hung on the edge of the operating table during general anesthesia without attention to protection, paralysis may occur due to compression. In the scalene or anterior scalene muscle syndrome, the most common injury is to the ulnar nerve.

　　The most common complications of the fracture of the base of the first metacarpal bone often include nerve and vascular injuries. The fracture and dislocation of the base of the first metacarpal bone can damage the radial nerve branches, causing abnormal sensory function of the 'three and a half fingers'. If the dislocation causes injury to the vessels, localized hematoma and pain may occur due to vessel rupture.

　　After the fracture of the base of the first metacarpal bone, the patient's palm will be locally swollen and painful, the thumb opposition and abduction movements will be limited, and the metacarpophalangeal and interphalangeal joints can still move.X-ray films can clearly show the fracture and dislocation of the base of the first metacarpal bone..

　　There are no special preventive measures for this disease, and it is best to avoid trauma.Mildly angulated old fractures that have little impact on the function of the thumb may not require treatment. If the angulation is large and the web is small, a wedge osteotomy at the base of the first metacarpal can be performed..

　　The diagnosis of fractures at the base of the first metacarpal, in addition to clinical manifestations, also requires indispensable auxiliary examinations. X-ray examination can be used to confirm the diagnosis, and electromyography may be necessary. It is important to differentiate fromFractures of the metacarpal neck andDistinguishing between fractures of the metacarpal shaft.. .

　　The diet of patients with fractures at the base of the first metacarpal should be nutritious, colorful, fragrant, and delicious, which can stimulate appetite. Feeding is required for those who have difficulty with arm movement. Eat more vegetables rich in vitamin C, such as tomatoes, amaranth, green vegetables, cabbage, and radishes, to promote the growth of calluses and the healing of wounds.
　　Early in the treatment, avoid spicy, hot, and greasy foods, and especially do not apply rich, nourishing foods too early, such as bone soup, fatty chicken, and braised fish. Otherwise, blood stasis will accumulate and be difficult to disperse, which will inevitably delay the course of the disease, slow down the growth of calluses, and affect the recovery of joint function in the future.

　　The treatment plan for fractures at the base of the first metacarpal is as follows:

　　Precautions before Treatment
　　1. Have the patient sit down, fold a clean gauze or handkerchief, and cover the injured hand with it.
　　2. Place the injured forearm across the chest and suspend and fix it with a triangular bandage or bandage. You can also wrap a triangular bandage or bandage around the patient's chest, tie it on the healthy side, and place a soft pad between the tie and the body.
　　3. After bandaging, check the patient's blood circulation.
　　4. The patient should be in a sitting position when transported to the hospital.

　　Western Medical Treatment Methods
　　Fractures that are fresh and easy to reduce can be corrected by traction and abduction of the thumb with one hand, and by applying pressure to the fracture site with the thumb of the other hand to correct angular deformities. After reduction, the thumb is fixed in an abducted position with a forearm cast for 4 to 6 weeks, and the cast should include the proximal phalanx. Unstable fractures can be treated with traction and fixation. Mildly angulated old fractures that have little impact on the function of the thumb may not require treatment. If the angulation is large and the web is small, a wedge osteotomy at the base of the first metacarpal can be performed.