eMedicine Specialties > Orthopedic Surgery > Hand & Upper Extremity

Bennett Fracture: Workup

Author: Steven V Priano, MD, Assistant Professor of Orthopedic Surgery, Department of Orthopedics and Sports Medicine, Ohio State University College of Medicine and Public Health
Coauthor(s): Mark E Baratz, MD, Professor, Department of Orthopaedics, Drexel University College of Medicine; Residency Director, Department of Orthopaedics, Allegheny General Hospital; Consulting Staff, Allegheny Orthopaedic Associates
Contributor Information and Disclosures

Updated: Jan 11, 2008

Workup

Imaging Studies

  • Radiography
    • Obtain standard posteroanterior, lateral, and oblique radiographs in patients with suspected fractures or dislocations of the thumb. Traction radiography may be used to assess the degree of comminution in appropriate fractures (eg, Bennett, Rolando, comminuted metacarpal base fractures).
    • Radiographs of the CMC joint are obtained by placing the palmar surface of the hand flat on the imaging plate for a true lateral view, allowing accurate assessment of the CMC joint. Pronate the hand and wrist approximately 20-30 º; and direct the imaging beam obliquely at 15 º; in a distal to proximal direction centered over the trapeziometacarpal joint. A broken V sign may be present on the lateral radiograph, indicating disruption of the normal V that is formed by the radial aspect of the trapeziometacarpal articulation. This may indicate undetected CMC joint subluxation.
  • Computed tomography and/or tomography scanning: These studies help define the degree of comminution within a fracture as well as suspected impaction of the articular surface.

More on Bennett Fracture

Overview: Bennett Fracture
Workup: Bennett Fracture
Treatment: Bennett Fracture
Follow-up: Bennett Fracture
Multimedia: Bennett Fracture
References

References

  1. Bennett EH. Fractures of the Metacarpal Bones. Dublin Med Sci J. 1882;73:72-75.

  2. Green DP, Stern PJ. Fractures of the metacarpals and phalanges. In: Green's Operative Hand Surgery. New York, NY. Churchill Livingstone;1999:711-772.

  3. Peimer CA, Wolfe SW, Elliot AJ. Metacarpal and carpometacarpal trauma. In: Surgery of the Hand and Upper Extremity. 1st ed. New York, NY. McGraw-Hill;1996:883-920.

  4. Rockwood CA, Green DP, Butler TE Jr. Fractures and dislocations of the hand. In: Rockwood and Green's Fractures in Adults. Philadelphia, Pa. Lippincott-Raven;1996:607-744.

  5. Soyer AD. Fractures of the base of the first metacarpal: current treatment options. J Am Acad Orthop Surg. Nov-Dec 1999;7(6):403-12. [Medline].

  6. Nagaoka M, Nagao S, Matsuzaki H. Trapeziometacarpal joint instability after Bennett's fracture-dislocation. J Orthop Sci. Jul 2005;10(4):374-7. [Medline].

  7. Sawaizumi T, Nanno M, Nanbu A, Ito H. Percutaneous leverage pinning in the treatment of Bennett's fracture. J Orthop Sci. 2005;10(1):27-31. [Medline].

  8. Lutz M, Sailer R, Zimmermann R, Gabl M, Ulmer H, Pechlaner S. Closed reduction transarticular Kirschner wire fixation versus open reduction internal fixation in the treatment of Bennett's fracture dislocation. J Hand Surg [Br]. Apr 2003;28(2):142-7. [Medline].

Further Reading

Keywords

thumb CMC fractures, thumb carpal-metacarpal fracture, thumb carpometacarpal fracture, Bennett's fracture, Bennett's fractures, thumb injury, thumb fracture

Contributor Information and Disclosures

Author

Steven V Priano, MD, Assistant Professor of Orthopedic Surgery, Department of Orthopedics and Sports Medicine, Ohio State University College of Medicine and Public Health
Steven V Priano, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons
Disclosure: Nothing to disclose.

Coauthor(s)

Mark E Baratz, MD, Professor, Department of Orthopaedics, Drexel University College of Medicine; Residency Director, Department of Orthopaedics, Allegheny General Hospital; Consulting Staff, Allegheny Orthopaedic Associates
Mark E Baratz, MD is a member of the following medical societies: Allegheny County Medical Society, American Academy of Orthopaedic Surgeons, American Association for Hand Surgery, American Orthopaedic Association, American Society for Surgery of the Hand, Orthopaedic Research Society, and Pennsylvania Orthopaedic Society
Disclosure: Nothing to disclose.

Medical Editor

Michael S Clarke, MD, Clinical Associate Professor, Department of Orthopedic Surgery, University of Missouri-Columbia School of Medicine
Michael S Clarke, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Academy of Pediatrics, American Association for Hand Surgery, American College of Surgeons, American Medical Association, Arthroscopy Association of North America, Clinical Orthopaedic Society, Mid-Central States Orthopaedic Society, and Missouri State Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Thomas R Hunt III, MD, John D Sherrill Professor and Director of Orthopaedic Surgery, Surgeon in Chief of UAB Highlands Hospital, Director of Hand and Upper Extremity Fellowship, University of Alabama at Birmingham
Thomas R Hunt III, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association for Hand Surgery, American Orthopaedic Association, American Orthopaedic Society for Sports Medicine, American Society for Surgery of the Hand, AO Foundation, Mid-America Orthopaedic Association, and Southern Orthopaedic Association
Disclosure: Tornier Consulting fee Review panel membership; Tornier Royalty None; Tornier Ownership interest None

CME Editor

Dinesh Patel, MD, FACS, Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital
Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Physicians of Indian Origin, American College of International Physicians, and American College of Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Harris Gellman, MD, Consulting Surgeon, Broward Hand Center; Voluntary Clinical Professor of Orthopedic Surgery and Plastic Surgery, Departments of Orthopedic Surgery and Surgery, University of Miami School of Medicine
Harris Gellman, MD is a member of the following medical societies: American Academy of Medical Acupuncture, American Academy of Orthopaedic Surgeons, American Orthopaedic Association, American Society for Surgery of the Hand, and Arkansas Medical Society
Disclosure: Nothing to disclose.

 
 
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