Mental health

June 2011

Clinical

Bennett fracture dislocation

Review and management

Volume 40, No.6, June 2011 Pages 394-396

Craig Brownlie

Daniel Anderson

Background

Bennett fracture dislocation is an intra-articular fracture of the base of the first metacarpal with resultant dislocation of the first carpometacarpal joint. The fracture is unstable, and with inadequate treatment leads to osteoarthritis, weakness and/or loss of function of the first carpometacarpal joint.

Objective/s

This article reviews the current literature on Bennett fracture and describes the clinical assessment and management of a Bennett fracture.

Discussion

Bennett fractures usually result from falling on an extended or abducted thumb or an impact onto a clenched fist. The patient presents with pain and loss of function of the first carpometacarpal joint. Management can involve closed reduction, with or without percutaneous Kirschner wire fixation, or open reduction and internal fixation, with adequate reduction and the maintenance of reduction being the key to a successful outcome. Due to the difficulty of management it is recommended that patients be referred to a specialist hand surgeon.

Bennett fracture is an intra-articular fracture of the base of the first metacarpal with resultant dislocation of the first carpometacarpal joint.1 It was initially described by Edward Hallaran Bennett in 1882.2 Since its first description, the treatment of this fracture has remained the subject of much debate. The fracture is unstable and concern exists as to whether inadequate reduction/fixation leads to long term consequences such as osteoarthritis, weakness, or loss of function of the first carpometacarpal joint.

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Correspondence afp@racgp.org.au

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