Clinicopathologic characteristics and surgical treatment of obsolete Bennett fractures / 中华创伤骨科杂志

ABSTRACT

Objective To investigate clinicopathologic characteristics of obsolete Bennett fractures and their surgical treatment and prognosis. Methods From August 2008 to April 2010,13 patients with obsolete Bennett fracture were admitted to our department.They were 12 men and one woman,with an average age of 34.3 years (from 17 to 42 years).They had a fracture history of over 4 weeks to as long as 12 weeks (average,7.9 weeks).In all patients,after X-ray examinations,the radio-dorsal ligament complex of the first carpometacarpal joint was properly released,fracture gaps were cleared up,fracture fragments were anatomically reduced and fixed with a Kirschner wire,and at last the first metacarpal joint was fixed with the Kirschner wire crossing the joint Postoperatively all patients were immobilized with cast plaster for 4 weeks before the Kirschner wires acrross the joint were removed.Gradual rehabilitation was conducted.The X-rays were taken every month. Results The patients were followed for 6 to 24 months(average,14 months).The fractures healed in all the patients,with an average healing time of 3 months.No dislocation of the joints occurred.Injury to articular cartilage of the trapezium bone occurred in one patient,and no apparent pain was experienced in the other 12 patients.According to the Total Active Motion assessment,the thumb function was rated as excellent in 9 cases,good in 2,moderate in one and poor in one,with a good to excellent rate of 84.6％.Conclusions In obsolete Bennett fractures,the radio-dorsal ligament complex of the first carpometacarpal joint will have cicatricial contracture,preventing reduction of the fragments of the radio-dorsal joint.Therefore it is important to properly release the radio-dorsal ligament complex to achieve anatomical reduction of the radio-dorsal joint.An injury history of over 3 months and complicated injury to the trapezium bone cartilage may be significant factors affecting the prognosis of obsolete Bennett factures.