7-year follow-up after open reduction and internal screw fixation in Bennett fractures

Abstract

Background Bennett fractures are unstable, and, with inadequate treatment, lead to osteoarthritis, weakness and loss of function of the first carpometacarpal joint. This study focuses on long-term functional and radiological outcomes after open reduction and internal fixation. Methods Between June 1997 and December 2005, 24 patients with Bennett fractures were treated with open reduction and internal fixation with screws at our center. Radiological and functional assessments including range of motion of the thumb and pinch and grip strength were performed 4 months post-procedure and at the long-term follow-up, on average 83 months after surgery. Results Reduction of the Bennett fracture was maintained as it was at the time of the procedure in 96 % of the cases when fixation with two lag screws was performed. At the 4-month follow-up, mean pinch and grip strength reached 92 ± 3 and 89 ± 4 % of the contralateral side, respectively. Long-term follow-up demonstrated no correlation between the accuracy of the fracture reduction and the development of post-traumatic arthritis. Conclusion Good clinical results could be observed, if successful reduction of the fracture was achieved and maintained. However, there was no correlation between the accuracy of the fracture reduction considering a gap and step \2 mm and the development of arthritis.

Percutaneous Fixation of First Metacarpal Base Fractures Using Locked K-Wires

“…19 The aim of treatment of these articular fractures is to obtain anatomic reduction. 7 Lutz and colleagues reported results at mean follow-up of 7 years comparing open screw fixation and percutaneous transarticular K-wire fixation of 32 large-fragment Bennett fractures. 20 Leclère and colleagues reported the long-term results of open screw fixation of 21 large-fragment Bennett fractures.…”

“…2,3 The action of the adductor pollicis and the abductor pollicis longus muscles produces displacement of the distal fragment, retraction of the first web (varus), and shortening due to dorsal dislocation. Several techniques have been described, including: locking plates, 5,6 open screw fixation, 7 and percutaneous K-wire fixation. Several techniques have been described, including: locking plates, 5,6 open screw fixation, 7 and percutaneous K-wire fixation.…”

Bennett Fracture

“…9 Twenty-three returned to their pre-injury work and sports. Of the 21 patients with no pre-injury degenerative changes, 10 (48%) had anatomical reduction, 7 (33%) had less than 1 mm stepoff, 3 (14%) had a < 1 mm gap, and 1 patient (5%) had a 1 mm step and gap.…”

Fractures and dislocation of the base of the thumb metacarpal

“…There are various reported means of fixation: pins (Bennani et al, 2012;Culp and Johnson, 2010;Greeven et al, 2012;Lutz et al, 2003); screws (Leclère et al, 2012;Meyer et al, 2003;Strömberg, 1977;Tourne et al, 1988); or plates (Pavic and Malović, 2013;Uludag et al, 2013).…”

“…Leclère et al reported their long-term results of treating 21 Bennett's fractures with a large fragment by open screw osteosyntheses. After 4 years, the overall strength of the hand was 89% of that of the contralateral side, but one patient had a secondary subluxation 9 weeks after surgery (Leclère et al, 2012). Lutz et al reported results at a mean of 7 years comparing open screw fixation to percutaneous trans-articular pinning in 32 Bennett's fractures with large fragments.…”