Treatment of a Bennett Fracture Using Tension Band Wiring

Zhang, Xu; Shao, Xinzhong; Zhang, Zhijie; Wen, Sumin; Sun, Jiayuan; Wang, Bin

doi:10.1016/j.jhsa.2011.12.025

Cited by 17 publications

(10 citation statements)

References 20 publications

(17 reference statements)

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“…This is a marked difference with the published literature, with reported loss of reduction in *30 % of cases, irrespective of the technique used [3,17,18]. This loss of reduction has also led some authors to consider other techniques such as tension band wiring [19]. But the wire loop used to lasso the Kirschner wire may conflict with the articular surfaces and lead to an increased incidence of osteoarthritis in the long-term.…”

Section: Discussionmentioning

confidence: 95%

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

Leclère

Jenzer

Hüsler

et al. 2012

Arch Orthop Trauma Surg

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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.

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Section: Discussionmentioning

confidence: 95%

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

Leclère

Jenzer

Hüsler

et al. 2012

Arch Orthop Trauma Surg

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“…With the development of arthroscopy, some doctors prefer arthroscopic reduction and internal fixation [17,18]. There are various methods of fixation: pins [3][4][5][6]19], screws [17,20], plates [9,21], tension bands [22,23], and external fixator [24]. Most researchers believed that anatomic congruity is more important than fracture fixation technique for longterm success.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of fluoroscopic examination in the treatment of Bennett’s fracture

Yin

Wang

et al. 2021

BMC Musculoskelet Disord

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Background Restoration of joint congruity is an important factor for the prevention of subsequent arthritis in patients with Bennett’s fracture. Surgical treatment of Bennett’s fracture is thus generally recommended for displaced intra-articular fractures to the proximal aspect of the thumb metacarpal. Fluoroscopic examination is used to evaluate the adequacy of closed reduction after pinning of Bennett’s fracture. The purpose of this study was to determine the accuracy of fluoroscopy to determine the reduction of Bennett’s fractures. Methods A model was created, to mimic a Bennett’s fracture utilizing ten fresh-frozen cadaveric hands. An oblique cut was made in the proximal aspect of the thumb metacarpal using an oscillating saw. The small oblique fragment involved 1/4–1/3 of the joint surface was then shifted in position creating a step-off or gap at the fracture site. An anatomical reduction model, gap models (1 mm, 2 mm, 3 mm), and step-off models (1 mm, 2 mm, 3 mm) were created using percutaneous fixation with two 1.0 mm Kirschner wires for each cadaveric hand. Fluoroscopic assessment then took place and was reviewed by 2 attending hand surgeons blinded to the actual position. Their estimated fluoroscopic position was then compared to the actual displacement. Results The step-off and gap on fluoroscopic examination showed a significant difference compared to the step-off and gap from direct visualization. The frequency of underestimation for the 3 mm displacement models from the fluoroscopic examination was 60%. The frequency for overestimated was 9% for the models in which displacement was within 2 mm (0, 1, 2 mm). Conclusions The assessment of articular gap and step-off using PA (postero-anterior), AP (antero-posterior), and lateral view of fluoroscopic examination is not accurate as compared to the examination by direct visualization. Surgeons need to be aware that PA, AP and lateral view of fluoroscopic examination alone may not be sufficient to judge the final position of a reduced Bennett’s fracture. Other methods such as live fluoroscopy in multiple different planes, 3-dimensional fluoroscopy or arthroscopic examination should be considered.

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“…Alternative fixation techniques are described, including skeletal traction [ 72 , 73 ], tension-band wiring [74] and arthroscopic-assisted fixation [ 38 , 75 , 76 ]. Arthroscopic-assisted percutaneous screw fixation using a two-portal technique minimises soft tissue dissection and permits direct articular visualisation [ 38 , 75 , 76 ].…”

Section: Review Of Bennett Fracture Managementmentioning

confidence: 99%