Intra-articular Corrective Osteotomy for Bennett's Fracture Malunion: A Rare Case Report

Bennett's fracture is an intra-articular fracture-dislocation at the base of the first metacarpal. If inadequately treated, it may lead to malunion and subluxation of the carpometacarpal joint, resulting in pain, stiffness, and functional impairment.

We report the case of a 28-year-old male software professional who presented 7 months after sustaining a left thumb injury with persistent pain, stiffness, and difficulty in thumb use. Radiographs revealed a malunited intra-articular fracture of the first metacarpal base with joint subluxation. The patient underwent intra-articular corrective osteotomy with fixation using screws and a trans-articular K-wire to restore joint congruity. At 12 weeks, he achieved full, pain-free thumb movements, and at 10 months, radiographs confirmed fracture union with a Kapandji score of 10/10.

Intra-articular corrective osteotomy is a viable and effective treatment for symptomatic Bennett's fracture malunion, particularly when performed before the onset of degenerative changes, leading to excellent pain relief and restoration of thumb function.