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Bennett Fracture
From WikiSM
Contents
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
- Axial load to a partially flexed thumb
- Unopposed muscles contribute to displacement
Risk Factors
- unknown
Differential Diagnosis
- Fractures
- Dislocations
- Tendinopathies
- Ligament Injuries
- Neuropathies
- Arthropathies
- Nail Bed Injuries
- Pediatric Considerations
- Other
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
- Tendon lacerations and neurovascular injuries are uncommon
- Acute Compartment Syndrome
See Also
External
- Sports Med Review Hand Pain: https://www.sportsmedreview.com/by-joint/hand/
References
- ↑ 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.
- ↑ GEDDA KO. Studies on Bennett's fracture; anatomy, roentgenology, and therapy. Acta Chir Scand Suppl. 1954;193:1-114