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Bennett Fracture

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Other Names

  • 1st metacarpal fracture

Background

  • Most common fracture involving base of thumb
  • Comminuted, two part intra-articular fracture of base of 1st metacarpal
    • Palmer radial fragment

Pathophysiology


Risk Factors

  • unknown

Differential Diagnosis


Clinical Features

  • General: Physical Examination Hand
  • Pain at base of thumb
  • Inspection: Swelling, bruising
  • Palpation: Tenderness at base of thumb

Evaluation

  • Standard Radiographs Hand
    • Robert's View: True AP of thumb
    • Intra-articular, 2 piece fracture of the base of the 1st metacarpal
    • Dorsolaterally displaced
  • Ultrasound
    • 5% sensitivity and 98.3% specificity[1]
    • Water bath technique can help
  • CT
    • Useful to clarify complex fracture patterns

Classification

  • Gedda Classification:[2]
    • Type 1: single ulnar fragment and subluxation of the metacarpal base
    • Type 2: an impaction fracture without subluxation of the first metacarpal
    • Type 3 an injury with a small ulnar avulsion fragment in association with metacarpal dislocation

Management

Nonoperative

  • Can be considered in stable, non-displaced fractures
  • Thumb spica cast

Operative

  • Most are considered unstable and require surgical intervention
    • Unstable fracture patterns
    • Intra-articular displacement of >1 mm

Return to Play

  • Needs to be updated

Complications


See Also


References


  1. Blaivas, Michael, et al. “Water bath evaluation technique for emergency ultrasound of painful superficial structures.” The American journal of emergency medicine 22.7 (2004): 589-593.
  2. GEDDA KO. Studies on Bennett's fracture; anatomy, roentgenology, and therapy. Acta Chir Scand Suppl. 1954;193:1-114
Created by:
John Kiel on 15 August 2019 23:01:58
Authors:
Last edited:
28 October 2020 13:38:36
Categories:
Trauma | Osteology | Finger | Hand | Wrist | Fractures