A long-term study following bennett's fracture

Abstract

Twenty-five patients with documented Bennett's Fractures were reviewed five to sixteen years following injury (Mean 9.6 years). The majority of fractures affected the dominant hand and occurred in males. Twenty-two patients were managed conservatively by plaster immobilisation. At review ten patients were asymptomatic and only two had significant symptoms. Examination revealed loss of movement in the trapeziometacarpal joint of the thumb in twenty-one cases. Five of these exhibited malrotation of the thumb. Review of the post reduction radiographs revealed separation of the fragments by 1 mm or more in sixteen patients, but symptoms at follow-up could not be correlated with accuracy of reduction. Twenty-three patients had a varus angulation of the first metacarpal base which could be correlated to the initial post-reduction displacement. There was no correlation with the restriction of movement. Although metacarpal length will only be maintained by reduction of the fracture, there was little evidence that imperfect reduction leads to significant symptomatic arthritis in the long term.

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

“…In this context, it is important to remember that other studies set the limit at 1 mm [21]. In our studies, the seven patients who developed signs of arthritis were adequately reduced with a gap and step of 2 mm or less.…”

“…(2) A second hypothesis is that the development of arthritis in our series was not post-traumatic but degenerative. Cannon et al [21] made the hypothesis that if little displaced fractures do go on to develop symptomatic arthritic changes, a significant number should be present to the surgeon in middle life for surgical treatment. In his review of 456 patients operated for arthritis of the first carpometacarpal joint, only 7 out of 456 patients had arthritis associated with a Bennett fracture.…”

Accuracy of Fluoroscopy in Closed Reduction and Percutaneous Fixation of Simulated Bennett's Fracture

“…Historically, the recommendation for closed reduction and pinning was based on the work of previous authors presenting the ability of this technique to achieve acceptable reduction without the need to open the fracture site. 12,13 These studies mostly were assessed using radiographs to verify adequate reduction. It is, however, sometimes difficult to accurately evaluate a Bennett's fracture with plain radiographs.…”

Injury-Fractures-Carpo-Metacarpal Joint and Metacarpal

“…The long term signifi cance of articular incongruity at the CMC joint, hence the need for open reduction, has been questioned. Cannon et al reviewed 25 patients with Bennett's fractures, which were mainly treated with plaster immobilisation [ 72 ]. After a mean follow-up of 9.6 years, 5 had malrotation, 21 had loss of movement, 16 had articular separation of more than 1 mm and 23 had varus angulation.…”