Ahmed is a recreational volleyball and soccer goalkeeper at the club level. He accidentally hit the ball trying to save it yesterday and the injury caused severe pain and swelling of the distal part of his thumb. He came with his painful swollen thumb (despite RICE treatment the previous day) and it was really tender and bruised at the tip and base of distal phalanx. There was a small hematoma in the finger pulp. His thumb movements were still intact.
His plain X-rays showed a minute fracture fragment of the base of the distal phalanx and a non-displaced fracture of the tip. An ultrasound of his finger tendons may be required if he had a suspected extensor tendon rupture. I placed his finger in a splint and advised him to return in 2 weeks.
I got the same injury while playing baseball diving back to second base. I jammed it into the leg of the second baseman. My thumb puffed up exactly the same as in the pictures above.
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