Arthroscopic-Assisted Treatment of Bennett Fractures: A Potentially Advantageous Operative Procedure?

Abstract

Background:

Articular fractures of the base of the first metacarpal (Bennett fractures) have been studied for years to determine the best method of reduction and fixation. This study aims to show the application of the percutaneous reduction and internal fixation technique with cannulated screws and arthroscopic assistance in articular fractures of the base of the first metacarpal.

Methods:

Descriptive cohort study in a series of 30 patients, the first cohort in our country and the largest series published so far, in which 8 patients presented with type 2A fracture and 19 patients with type 2B of the Torres-Becerra classification underwent the mentioned technique under direct vision and control of the articular reduction by arthroscopy evaluating the intraoperative characteristics of the articular surface, stability of de reduction and fixation. Assessment of functional and rehabilitation results with a minimum postoperative follow-up of 6 to 12 months.

Results:

The senior author has used this technique with consistent clinical outcomes to improve reduction and fixation of intra-articular base fractures of first metacarpal bone (Bennett), reducing the articular step-off and gapping permitting an early rehabilitation progress with satisfactory functional results.

Conclusions:

We can suggest that this surgical method for the treatment of Bennett fractures may offer multiple advantages: adequate debridement of the trapeziometacarpal joint, direct visualization of the articular surface during reduction, achieving greater precision in fixation with minimum morbidity, imperceptible incisions and scars, shorter surgical time, and fewer associated complications.

Keywords

arthroscopy base of thumb Bennett fracture percutaneous trapeziometacarpal joint

Get full access to this article

View all access options for this article.

References

Berger

. A technique for arthroscopic evaluation of the first carpometacarpal joint. J Hand Surg Am. 1997;22(6):1077-1080. doi:10.1016/S0363-5023(97)80052-4.

Culp

Johnson

. Arthroscopically assisted percutaneous fixation of Bennett fractures. J Hand Surg Am. 2010;35(1):137-140. doi:10.1016/j.jhsa.2009.10.019.

Menon

. Arthroscopic management of trapeziometacarpal joint arthritis of the thumb. Arthroscopy. 1996;12(5):581-587. doi:10.1016/s0749-8063(96)90198-x.

Badia

. Arthroscopy of the trapeziometacarpal and metacarpophalangeal joints. J Hand Surg Am. 2007;32(5):707-724. doi:10.1016/j.jhsa.2007.02.020.

Badia

. Trapeziometacarpal arthroscopy: a classification and treatment algorithm. Hand Clin. 2006;22(2):153-163. doi:10.1016/j.hcl.2006.02.006.

Zemirline

Lebailly

Taleb

, et al Arthroscopic assisted percutaneous screw fixation of Bennett’s fracture. Hand Surg. 2014;19(2):281-286. doi:10.1142/S0218810414970053.

Pomares

Strugarek-Lecoanet

Dap

, et al Bennett fracture: arthroscopically assisted percutaneous screw fixation versus open surgery: functional and radiological outcomes. Orthop Traumatol Surg Res. 2016;102(3):357-361. doi:10.1016/j.otsr.2016.01.015.

Marcovici

Atzei

Cozzolino

, et al Arthroscopic assisted treatment of thumb metacarpal base articular fractures. Arthrosc Tech. 2021;10(7):e1783-e1792. doi:10.1016/j.eats.2021.03.022.

Gedda

. Studies on Bennett’s fracture; anatomy, roentgenology, and therapy. Acta Chir Scand Suppl. 1954;193:1-114.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.02 MB