Bennetts

Bennett's Fracture

Bennett's fracture is a specific type of fracture of the base of the first metacarpal bone which extends into the carpometacarpal (CMC) joint. This injury is common and significant due to its potential impact on the thumb's mobility and strength. The fracture is named after Edward Hallaran Bennett, an Irish surgeon who first described it in 1882.

Causes and Mechanism

Bennett's fracture typically occurs as a result of a forceful axial load applied to a partially flexed metacarpal, such as during a fistfight or from a fall onto an outstretched hand. The mechanism involves a direct impact that transmits force to the first metacarpal, often leading to a fracture dislocation due to the pull of the abductor pollicis longus muscle.

Symptoms and Diagnosis

Patients with Bennett's fracture commonly present with pain, swelling, and limited mobility in the thumb. Visibly, the thumb may appear shortened and misaligned. Diagnosis is primarily confirmed through X-ray imaging, which reveals the fracture and any displacement.

Treatment

Treatment of Bennett's fracture depends on the severity and displacement of the fracture. Non-displaced fractures can often be managed with splinting or casting for immobilization. However, displaced fractures usually require surgical intervention to realign the bones and restore function. Surgical options may include closed reduction with percutaneous pinning or open reduction with internal fixation (ORIF).

Complications

If not properly treated, Bennett's fracture can lead to complications such as arthritis of the CMC joint, chronic pain, and reduced thumb mobility and strength. Early and appropriate management is crucial to minimize these risks and ensure optimal recovery.

Rehabilitation

Rehabilitation plays a vital role in the recovery process, typically beginning after the removal of splints or casts. Physical therapy is aimed at restoring thumb movement, strength, and function. Exercises may include thumb flexion, extension, and opposition movements, gradually increasing in intensity as healing progresses.

Conclusion

Bennett's fracture is a significant injury that requires prompt and appropriate treatment to prevent long-term disability. With proper management, most individuals can expect to regain functional use of their thumb.

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