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Closed reduction and percutaneous fixation: Safe treatment technique for Bennett's Fracture

Closed reduction and percutaneous fixation: Safe treatment technique for Bennett's Fracture Closed reduction and percutaneous fixation: Safe treatment technique for Bennett's Fracture
Closed reduction and percutaneous fixation: Safe treatment technique for Bennett's Fracture Closed reduction and percutaneous fixation: Safe treatment technique for Bennett's Fracture

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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."

Source:

Hand Surgery and Rehabilitation

Article:

Bennett's fracture: Comparative study between open and closed surgical techniques

Authors:

S.J.M.Kamphuis et al.

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