A bennett fracture is a fracture of the base of the thumb resulting from forced abduction of the first metacarpal. A bennett fracture is a twofragment intraarticular thumb metacarpal base fracture. Aug 22, 2019 it is stated in the literature that the degree of restoration of the articular alignment is the main prognostic factor for the fracture. A bennetts fracture is an intraarticular fracture of the base of the first metacarpal with resultant dislocation of the first carpometacarpal joint. Bennett fracture article about bennett fracture by the free. The combination of bennett fracture dislocation and trapezium fracture is rare and presents a diagnostic and therapeutic challenge. He was treated with kwire fixation without a capsulotomy. Bennett fractures usually result from falling on an extended or abducted thumb or an impact onto a clenched fist. The volar approach of gedda and moberg1 is considered the standard approach to the cmc joint of the thumb if there is an extraarticular, bennett, rolando, or severely comminuted fracture. A bennett fracture is a common injury that involves an intraarticular fracture at the base of the first metacarpal. It is performed on an outpatient basis under regional anaesthesia, with the patient comfortably lying on his or her back, the hand held vertically, the thumb under axial traction. Clay matthews broken thumb diagnosed as a bennetts fracture. Frac tures comminutives 6 % faciles t reconna3tre avec des clich6s. A bennett s fracture is an intraarticular fracture of the base of the first metacarpal with resultant dislocation of the first carpometacarpal joint.
It was 25 years after bennetts original manuscript that lambotte described the. Combined bennett fracture dislocation and trapezium. Cureus combined bennett fracture dislocation and trapezium. In the first mechanism, a direct axial loading on a flexed. The bennetts fracture is caused by a falling or any types of trauma affecting the patients hand and specifically the thumb joint. The bennett fracture is an intraarticular fracture of the base of the first metacarpal.
Despite a relatively simple appearance on radiographs, bennett fractures are considered unstable in evaluating and treating these fractures positioning the patient with thumb. Treatment of this fracture is usually done by open reduction and. The sharp pain often radiates up into the forearm and across into the wrist and hand. They are most commonly the result of a traumatic downwards force through the thumb, normally seen in boxers and contact sports players.
It is the most common base of metacarpal fracture 3. It is the most common fracture to affect the thumb and. When this injury occurs, the abductor pollicis longus pulls the thumb metacarpal proximally, dislocating it and causing an adducted posture of the thumb and consequent narrowing of the thumbweb space. The fracture is often accompanied by swelling and bruising around the thumb and wrist. Bennetts fractures can result from any significant forces placed on the base of the thumb, such as sports, falls and accidents. A rolando fracture is a threefragment intraarticular thumb metacarpal base fracture. Bennetts fracture is a condition in which the base of the metacarpal bone gets fractured where it articulates with the trapezium. A fracture of the base of the fifth metacarpal bone was considered as an extraarticular fracture. His injury occurred when he ran into a cement post.
This hand surgery is highly specialized, it derives from arthroscopic surgery for osteoarthritis of the base of the thumb rhizarthrosis. In sports surgery, articular fractures of the base of the first metacarpal bone thumb, also called bennetts fractures, are relatively common. Apr 06, 2015 fractures of the 1st metacarpal base at the base of the thumb can damage the joint and lead to arthritis, weakness, and chronic pain. Sep 07, 2018 in 1882, edward hallaran bennett, md, described the fracture of the base of the first metacarpal that bears his name. Bennett fracture synonyms, bennett fracture pronunciation, bennett fracture translation, english dictionary definition of bennett fracture.
Bennett fracture definition of bennett fracture by the free. Bennett fracture definition of bennett fracture by the. If these fractures heal in a displaced position, a traumatic arthritis quickly develops at the thumb base. The major goal in the treatment of metacarpal fractures is to restore the normal function of the hand. Two different mechanisms have been proposed for the causation of a trapezium fracture along with a bennett fracture 45. Bennett fracture definition of bennett fracture by. He fractured his right clavicle as well as his left thumb. A bennetts fracture occurs when the metacarpal bone in the thumb breaks and dislocates at the base of the thumb. Caused by an axial force directed against the partially flexed metacarpal, such as during a fight or fall onto the thumb. Search checked by martin smith a 32 year old man presents to the emergency department following a fight.
As all joint fractures, finger fractures must be operated on as soon as they are displaced. A bennett s fracture is the term for a fracture and dislocation of the base of the thumb. Bennetts fracture is named after edward hallaran bennett, professor of surgery 18371907, who first described it in 1882. A simple fracture is one in which there is no contact of the broken bone with the outer air, i. A bennett fracture occurs when an axial force is transmitted through a partially flexed thumb metacarpal. A bennetts fracture is a fracture plus dislocation of the metacarpal bone at the base of the thumb. Sports surgery bennetts fractures arthroscopy of the. Radiography reveals an undisplaced bennett s fracture. Bennett fracture is a fracture of the base of the first metacarpal bone which extends into the carpometacarpal cmc joint. A bennetts fracture, named after irish surgeon edward hallaran bennett, who first described it in 1882, is an injury that occurs at the base of the. Bennett described the fracturedislocation of the thumb metacarpal that bears his name in 1882 and again in 1886 fig. It is pathologically and radiographically analogous to the bennett fracture of the thumb. Acutely this is always accompanied by haematoma and inflammation. It is quite unstable due to unopposed extensor carpi ulnaris pull on the fracture fragment, which causes migration and subluxation of the fragment.
Bennetts fractures wire technique michael jablon history and clinical presentation a 35yearold, righthanded dentist injured his left, nondominant thumb in a bicycle accident. There is the same fracture of the metacarpal as in bennett s fracture but, as well as this, there is a large dorsal fragment, resulting in a comminuted y or tshaped intraarticular fracture at the base of the thumb metacarpal. The fracture must involve the first carpometacarpal joint to be called a bennett fracture. The thumb carpometacarpal cmc joint geometry is similar to two interlocking saddles, with their surfaces at 90 degrees to each other. The open volar dislocation was reduced and the collateral ligaments, the extensor tendons, and the dorsal capsule, were surgically. The rolando fracture is a comminuted intraarticular fracture through the base of the first metacarpal bone the first bone forming the thumb.
The specific fracture he described passed obliquely across the base of the bone, detaching the greater part of the articular surface. Often, these fractures result from a blow, deliberate or not. This is a fracture consisting of 3 distinct fragments. Management of undisplaced bennetts fracture emergency. In the first mechanism, a direct axial loading on a flexed thumb results in the dorsoradial subluxation.
Bennett fracture is an intraarticular fracture of the base of the first metacarpal with resultant dislocation of the first carpometacarpal joint. A posteroinferior glenoidrim enthesophyte arising at the site of insertion of the posterior band of the inferior glenohumeral ligament complex, which is seen in athletes that use overhead throwing movementse. Intraarticular fractures at the first trapeziometacarpal joint include bennett, rolando, and vertical intraarticular fractures of the trapezium. Location on bone describe the location shaft, metaphysis, epiphysis proximal, distal. Early recognition makes closed or open reduction, percutaneous pin fixation and plaster immobilization possible. Combined bennett fracture dislocation and trapezium fracture. Bennett fracture is a fracture of the base of the first metacarpal bone which extends. A reverse bennett fracturedislocation is a fracturedislocation of the base of the 5 th metacarpal bone. Location on bone describe the location shaft, metaphysis, epiphysis. The fracture is unstable and inadequate treatment leads to osteoarthritis, weakness and loss of function of the first carpometacarpal joint.
Aug 08, 2016 thumb fracture bennett s fracture treatment. The form and severity of this fracture depends on the position of the hand at the moment of hitting the ground. It is defined as an intraarticular twopart fracture of the base of the first metacarpal bone. Associations posterior labral injury, posterior instability, anterior labral. Trapezium is one of the eight carpal bones in the wrist that forms a joint at the base of the thumb known as first carpometacarpal joint. If intraarticular trapeziometacarpal fractures such as the bennett or rolando fractures are allowed to heal in a displaced position, significant posttraumatic osteoarthritis of the base of the thumb is virtually assured. Pdf 18 patients with bennetts fracture were evaluated after a mean followup period. These hand fractures compromise the function of the trapezometacarpal joint, which is the main joint of the thumb. Media in category bennetts fracture the following 8 files are in this category, out of 8 total. Bennett fracture definition of bennett fracture by medical. Sep 07, 2018 a bennett fracture occurs when an axial force is transmitted through a partially flexed thumb metacarpal.
A 35yearold, righthanded dentist injured his left, nondominant thumb in a bicycle accident. Fracture of the base of the first metacarpal bone which extends into the carpometacarpal joint. The portion of the metacarpal onto which the volar oblique ligament inserts remains in anatomic position, and the remainder of the articular base subluxates in a dorsal, radial, and proximal direction because of the pull of the apl. In 1882, edward hallaran bennett, md, described the fracture of the base of the first metacarpal that bears his name. The bennett fracture is an intraarticular fracture of the base of the first metacarpal bone that separates the palmar ulnar aspect of the first metacarpal base from the remaining first metacarpal and known as the most common fracture found in the base of the thumb. Bennetts fracture fracture of the base of the thumb. Reverse bennett fracturedislocation radiology reference.
Bennett lesion definition of bennett lesion by medical. The fracture is unstable and concern exists as to whether inadequate reduction. He complains of pain around the base of the right thumb metacarpal. There is the same fracture of the metacarpal as in bennetts fracture but, as well as this, there is a large dorsal fragment, resulting in a comminuted y or tshaped intraarticular fracture at the base of the thumb metacarpal.
Bennett described the anatomic details of the fracture and suggested that early diagnosis and treatment are imperative to prevent loss of function of this highly mobile joint. A type 2 fracture represents an impaction fracture without subluxation of the thumb metacarpal. Bennett described the fracture dislocation of the thumb metacarpal that bears his name in 1882 and again in 1886 fig. Finally, a type 3 fracture represents an injury with a small ulnar avulsion. The width of this mentioned angle affects the localization of the fracture. Forces that impact the bent thumb cause this injury. This is a 3part fracture at the base of the thumb metacarpal. A bennetts fracture from trauma causes a very intense immediate sharp pain around the fracture site at the base of the thumb. Jun 20, 2018 bennetts fracture is a condition in which the base of the metacarpal bone gets fractured where it articulates with the trapezium.
The patient presents with pain and loss of function. The full text of this article is available in pdf format. We report a case of a young adult male who presented with such an injury after a motor vehicle accident. Le double embrochage intermetacarpien dans le traitement. Articular fractures of the base of the 1 st metacarpal, also known as bennett fractures, are relatively common finger fractures.
This type of compression along the metacarpal bone is often sustained when a person punches a hard object, such as the skull or tibia of an opponent, or a wall. Bennett fracture article about bennett fracture by the. The action of the abductor pollicis longus causes distraction of the fracture fragments. Essentially the three fragments of the fracture are. A bartons fracture is an intraarticular fracture of the distal radius with dislocation of the intraarticular component distinguishes this fracture from a smiths or a colles fracture. A bennett fracture has been associated with just 15% of all trapezium fractures 23. The acumed hand fracture system is designed to provide both standard and fracturespecific fixation for metacarpal and phalangeal fractures, as well as fixation for fusions and osteotomies. A bennett s fracture is a fracture plus dislocation of the metacarpal bone at the base of the thumb.
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