2.  HPI- 55 year male presents to the ED c/o left thumb
pain after punching a police officer in his bullet proof
vest.
 PMX- HIV, DM
 Allergies- Codeine
 Meds- Non currently
 Social- Crack Cocaine

3.  P- 110- BP 160/80 RR 16 T- 98.8
 HEENT- NCAT
 Cardio- S1 S2
 Neuro- Intact
 Ext. Left elbow and forearm unremarkable. Upon
palpation there is pain and swelling noted at the
base of the 1st metacarpal. Distal pulses are intact

6.  Immobilization with a thumb spica
 Pain control
 Orthopedic referral
 Typically requires operative management

7.  Anatomy
 - involves 3 part fx at base of metacarpal;
- inaddition to volar lip fx, as seen with a Bennett fx,
there is also large dorsal fragment, resulting in Y or T
shaped intra-articular fx;
 - Fx is a comminuted intra-articular fx at base of thumb
metacarpal, even if Y or T is not present;