November 15, 2010

Bennett's Fracture Dislocation

  • Most frequent fracture at the base of the first metacarpal
  • Fracture dislocation resulting from axial loading to a partially flexed thumb (i.e., in a fist fight)
  • Oblique fracture involves the carpometacarpal joint, resulting in a volar fragment attached to the trapezium and the distal metacarpal fragment displacing proximally/radially/dorsally by pull of abductor pollicis longus
  • First CMC joint is a saddle-shaped bone, any minor malalignment results in substantial articular incongruity. This fracture dislocation frequently requires open reduction and fixation
  • Oblique fracture line with a triangular fragment at the first metacarpal base
  • Proximal displacement of the metacarpal
  • Important to note the size of the triangular volar fragment and the degree of displacement of the metacarpal fragment

1. Robinson P. Essential Radiology for Sports Medicine, 2010.
2. Bennett's Fracture Dislocation. Wheeless' Textbook of Orthopedics

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