eMedicine Specialties > Orthopedic Surgery > Hand & Upper Extremity
Bennett Fracture: Workup
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.
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References
Bennett EH. Fractures of the Metacarpal Bones. Dublin Med Sci J. 1882;73:72-75.
Green DP, Stern PJ. Fractures of the metacarpals and phalanges. In: Green's Operative Hand Surgery. New York, NY. Churchill Livingstone;1999:711-772.
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.
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.
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].
Nagaoka M, Nagao S, Matsuzaki H. Trapeziometacarpal joint instability after Bennett's fracture-dislocation. J Orthop Sci. Jul 2005;10(4):374-7. [Medline].
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].
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
Workup: Bennett Fracture