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Bennett Fracture Workup

  • Author: Mark E Baratz, MD; Chief Editor: Harris Gellman, MD  more...
 
Updated: Jun 06, 2016
 

Imaging Studies

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; see the images below).

Radiograph of a Bennett fracture. Radiograph of a Bennett fracture.
Rolando fracture. This is differentiated from a BeRolando fracture. This is differentiated from a Bennett fracture because of the presence of intra-articular comminution.

Radiographs of the carpometacarpal (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 20-30º, and direct the imaging beam obliquely at 15º 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.

Tomography or computed tomography (CT) can help define the degree of comminution within a fracture, as well as suspected impaction of the articular surface.

 
 
Contributor Information and Disclosures
Author

Mark E Baratz, MD Orthopedic Specialists of UPMC

Mark E Baratz, MD is a member of the following medical societies: Orthopaedic Research Society, Pennsylvania Orthopaedic Society, Allegheny County Medical Society, American Academy of Orthopaedic Surgeons, American Association for Hand Surgery, American Orthopaedic Association, American Society for Surgery of the Hand

Disclosure: Received royalty from Integra Life Sciences for none; Received consulting fee from Integra Life Sciences for speaking and teaching; Received grant/research funds from Integra Life Sciences for none; Received consulting fee from Elizur for consulting.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Thomas R Hunt III, MD Professor and Chairman, Joseph Barnhart Department of Orthopedic Surgery, Baylor College of Medicine

Thomas R Hunt III, MD is a member of the following medical societies: American Orthopaedic Association, American Orthopaedic Society for Sports Medicine, Southern Orthopaedic Association, AO Foundation, American Academy of Orthopaedic Surgeons, American Association for Hand Surgery, American Society for Surgery of the Hand, Mid-America Orthopaedic Association

Disclosure: Received royalty from Tornier for independent contractor; Received ownership interest from Tornier for none; Received royalty from Lippincott for independent contractor.

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, Leonard M Miller School of Medicine, Clinical Professor, Surgery, Nova Southeastern 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, Arkansas Medical Society

Disclosure: Nothing to disclose.

Additional Contributors

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, Arthroscopy Association of North America, American Academy of Pediatrics, American Association for Hand Surgery, American College of Surgeons, American Medical Association, Clinical Orthopaedic Society, Mid-Central States Orthopaedic Society, Missouri State Medical Association

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author Steven V Priano, MD, to the original writing and development of this article.

References
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Radiograph of a Bennett fracture.
Percutaneous pinning of a Bennett fracture.
Rolando fracture. This is differentiated from a Bennett fracture because of the presence of intra-articular comminution.
 
 
 
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