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Related Experiment Videos

Bennett's fracture: Comparative study between open and closed surgical techniques.

S J M Kamphuis1, A P A Greeven2, S Kleinveld3

  • 1Department of Surgery, Elisabeth-TweeSteden Hospital, Hilvarenbeekseweg, 60, 5022 GC Tilburg, The Netherlands.

Hand Surgery & Rehabilitation
|January 15, 2019
PubMed
Summary

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Closed reduction and percutaneous fixation (CRPF) offers safe treatment for Bennett fractures when fixation gaps are less than 2mm. Open reduction and internal fixation (ORIF) may lead to higher pain scores, despite similar functional outcomes.

Area of Science:

  • Orthopedic Surgery
  • Trauma Surgery
  • Hand Surgery

Background:

  • Bennett fractures are common thumb base injuries requiring surgical intervention.
  • Long-term outcomes of different surgical techniques for Bennett fractures are not well-established.

Purpose of the Study:

  • To compare long-term outcomes of open reduction and internal fixation (ORIF) versus closed reduction and percutaneous fixation (CRPF) for surgically treated Bennett fractures.
  • To identify factors predicting post-traumatic arthritis after surgical fixation.

Main Methods:

  • Retrospective analysis of 50 patients treated between 1994 and 2010.
  • Assessment included DASH, VAS pain scores, sensory testing, grip/pinch strength, and radiographic analysis for post-traumatic arthritis at a mean 10-year follow-up.
Keywords:
Arthrose post-traumatiqueBennett fractureClosed reduction and percutaneous fixationFracture de BennettOpen reduction and internal fixationOstéosynthèse percutanéePost-traumatic arthritisReduction et ostéosynthèse à foyer ouvertSurgical treatmentTraitement chirurgical

Related Experiment Videos

  • Comparison between ORIF (n=35) and CRPF (n=15) groups.
  • Main Results:

    • No significant differences in grip or pinch strength between ORIF and CRPF.
    • ORIF group reported higher pain scores (VAS) and required more re-operations (5 patients).
    • A persistent step-off or gap >2mm after fixation strongly correlated with post-traumatic arthritis at 10 years.

    Conclusions:

    • Both ORIF and CRPF provide good functional outcomes for Bennett fractures.
    • CRPF is a safe treatment option if the post-fixation step-off/gap is <2mm.
    • Minimizing post-fixation step-off/gap is crucial for preventing long-term post-traumatic arthritis, potentially more so than achieving anatomical reduction via ORIF.