A Study of Bennett's Fracture: Special Reference to Fixation by Percutaneous Pinning

Abstract

In the present study radiological evaluation of 45 cases of Bennett's fracture reveals that different types of fracture dislocations correlate with late and typical deformities of the metacarpal joint surface. Functional results with special reference to treatment by closed reduction and percutaneous pinning show that this method was successful in most cases treated (92%). It is concluded that percutaneous pinning offers a simple and reliable way of fixation which eliminates the need for X-rays during the healing period. Untoward effects on the joints caused by the pins were not observed and the incidence of secondary arthrosis was not higher than reported for other methods of internal fixation. 4 11 30 Scand J Plast Reconsfr Surg 5 Scand J Plast Surg Recontr Surg Hand Surg Downloaded from informahealthcare.com by University of Toronto on 11/19/14 For personal use only. 26, 3. ThorCn, L. 1956. A new method of extension treatment in Bennett's fracture. Acta Chir Scand 110, 485. Scand J Plast Reconstr Surg 5 Scand J Plast Surg Recontr Surg Hand Surg Downloaded from informahealthcare.com by University of Toronto on 11/19/14For personal use only.

Common Fractures and Dislocations of the Hand

“…Bennett fracture is a two part fracture-dislocation in which the entire thumb metacarpal is subluxated dorsally, radially, and proximally by the pull of the abductor pollicis longus [4][5][6][7] (Fig. 1, left).…”

Current concepts in managing fractures of metacarpal and phalangess

“…[35] With the advent and wide use of C arm, most of the Bennet's fracture can be managed with CRIF, the manoeuvre of which should be axial traction, abduction ,pronation of distal fragment with corrective force over the dorsal apex angulation. Ideally 2 K wires, both across the fracture [Figure 8] or one across the fracture and the other across the carpometacarpal joint[36] or intermetacarpal (engaging first and the second) for a period of four-six weeks will generally suffice. [37] Sometimes if there is delayed presentation or the fragment involves >30 to 40% of the base of first metacarpal it may need ORIF.…”

Metacarpal fractures

“…Placing one or 2 pins from the metacarpal shaft into the trapezium while maintaining reduction can counteract the deforming force of the abductor pollicis longus. 33 In some cases, a combination of pinning techniques is useful. For Bennett and CMC base fractures, crossed pins are useful for securing fracture alignment while transfixation or transarticular pins are helpful to maintain reduction of a CMC dislocation (Fig 5).…”