[Bennett's fracture-luxation. Osteosynthesis by the dorsal approach]

The use of the palmar approach, known as the Moberg approach, for open reduction and osteosynthesis of Bennett's fracture-dislocation has the disadvantage of requiring fairly extensive disinsertion of the thenar muscles and of opening the trapezio-metacarpal articulation. The approach proposed, dorsal and parallel to the ulnar border of the first metacarpal, allows easy access to the fracture site with little or no muscle disinsertion, and without opening the articulation. Once reduction is obtained, it is temporarily held in place by a pin through the dorsal aspect, and then definitively by a screw drawing the fragments together. The one danger in this approach is in damaging a sensory branch of the radial nerve which must be carefully protected.