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Closed reduction and percutaneous fixation can be considered a safe treatment for a Bennett fracture when the
persistent step-off and gap after fixation does not exceed 2 mm.
The closed reduction and
percutaneous fixation (CRPF) is a safe treatment option for Bennett's fracture
when the persistent step-off and gap after fixation do not exceed 2 mm,
explained in a study published in 'Hand Surgery and Rehabilitation'.
S.J.M.Kamphuis et al. aimed to
examine the long-term outcomes of surgically treated Bennett fractures by
comparing the open reduction and internal fixation (ORIF) with CRPF. This
comparative retrospective study considered the patients treated between the
year 1994 to 2010 during an outpatient visit via a validated questionnaire
(i.e. DASH, pain assessed through VAS), sensory testing, grip- and
pinch-strength and radiographic analysis for post-traumatic arthritis.
Total of 50 patients with a mean
follow-up of 10 years and age 34 years participated in this study. Thirty-five
patients used ORIF and fifteen patients used CRPF. No differences observed in
the grip- and pinch strength.
Five ORIF-treated patients needed
re-operations. ORIF-treated patients depicted higher pain scores (VAS). There
was no correlation between surgical technique and functional outcomes. At the
10 year follow-up, a persistent step-off or gap larger than 2 mm following
surgical fixation was significantly correlated with post-traumatic arthritis.
The need to perform ORIF for
anatomical reduction seems to be least important in preventing post-traumatic
arthritis as a persistent step-off. A gap of more than 2 mm was found to be
significantly correlated with the development of post-traumatic arthritis.
The study authors concluded that
both the techniques lead to good functional outcomes, although persistent pain
was seen in the ORIF-treated patients."
Hand Surgery and Rehabilitation
Bennett's fracture: Comparative study between open and closed surgical techniques
S.J.M.Kamphuis et al.
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