Tag Archive for: Bennett fracture

Comparison of Functional Outcome Between Trans– 2nd Metacarpal Fixation and Trans-Trapezius Fixation with K-Wire for Bennett Fracture

Vol 7 | Issue 2 | July-December 2021 | page: 01-03 | Vishal V. Navale, Manasee Gulati

DOI-10.13107/ti.2021.v07i02.015


Author: Vishal V. Navale [1], Manasee Gulati [2]

[1] Department of Orthopaedics, Mysore Medical College and Research Institute, Mysore, Karnataka, India.
[2]Department of Physical Therapy, Manipal Academy of Higher Education, Manipal Hospitals, Bengaluru, Karnataka, India.

Address of Correspondence
Dr. Vishal V. Navale, Department of Orthopaedics, Mysore Medical College and Research Institute, Mysore, Karnataka, India.
E-mail: nvvishal2010@gmail.com


Abstract

Introduction: An articular fracture of the base of the thumb metacarpal consisting of a single, variable-sized, volar-ulnar fracture fragment is termed Bennett fracture. In the studies conducted so far there has been paucity in the knowledge about the methods of k wire fixation for the Bennett fracture and hence the purpose of this study is to compare functional outcome between the trans – 2nd metacarpal fixation and trans – trapezius fixation with K wire for Bennett fracture.
Methods: Patients were 18 years and above with no previous injury on the 1st metacarpal . Final assessment was performed from six months to nine months after the treatment with the DASH Score, VAS scale for pain, Hand Grip strength by Dynamometer. Radiographic images were taken at 6 months post-op in two separate views to evaluate post-traumatic arthritis of the first CMC joint.
Results: Statistical analysis showed a correlation between Pain and DASH score to be 0.946 in TTZ group and 0.966 in T2MC group and hence signifies that patients in T2MC group had a better functional outcome with lower DASH score and lower pain score. Significant correlation was seen between Pain and Grip strength, with -0.587 in TTZ group and -0.482 in T2MC group. Higher pain score correlated with higher DASH score and lower Grip strength and hence we can conclude that T2MC had a better functional outcome post-surgery than TTZ technique of fixation. Post op radiographs showed that T2MC group of patients had a better outcome with less arthritic complications and less pain and better grip strength.
Conclusion: This study gives us the overview about the two fixation methods of Bennett fracture , and that when trans 2nd metacarpal fixation is done , there are less chances of arthritis of the CMC joint as well as better functional outcomes post operatively as compared to trans trapezial fixation and hence guides a surgeon to make a decision about the technique of fixation to be employed during fixing such fracture.
Keywords: Bennett fracture, Trans-trapezial, Trans- 2nd metacarpal, Functional outcome


References

1. Drelich M, Godlewski P. Metacarpal fractures. Orthop Traumatol Rehabil 2004;6:331–335. 2. Kahler DM. Fractures and dislocations of the base of the thumb.J South Orthop Assoc 1995;4:69 –76. 3. Gedda KO, Moberg E. Open reduction and osteosynthesis of the so-called Bennett fracture in the carpo-metacarpal joint of the thumb. Acta Orthop Scand 1952;22:249–57. 4. Yin Y, Wang Y, Wang Z, Qu W, Tian W, Chen S. Accuracy of fluoroscopic examination in the treatment of Bennett fracture. BMC Musculoskelet Disord. 2021 Jan 4;22(1):3. doi: 10.1186/s12891-020-03867-1. PMID: 33397336; PMCID: PMC7783999. 5. Fractures of the Metacarpals and Phalanges: Charles S. Day. Greens Operative Hand surgery –Elsevier, 7th edition 2016, pg 272. 6. Fischborn T, Beckenbauer D, Held M, Daigeler A, Medved F. Analysis of operative techniques of fractures of the first metacarpal base. Ann Plast Surg 2018;80:507–14. 7. Hand – surgical treatment: Thomas P Ruedi. AO principles of fracture management – AO Publishing , second edition 2007, pg 683. 8. Kamphuis SJM, Greeven APA, Kleinveld S, Gosens T, Van Lieshout EMM, Verhofstad MHJ. Bennett fracture: Comparative study between open and closed surgical techniques. Hand Surg Rehabil. 2019 Apr;38(2):97-101. 9. Crosby CA, Wehbe MA, Mawr B. Hand strength: normative values. J Hand Surg Am 1994;19:665–70. 10. van Niekerk JL, Ouwens R. Fractures of the base of the first metacarpal bone: results of surgical treatment. Injury 1989;20:359–62. 11. Kamphuis SJM, Greeven APA, Kleinveld S, Gosens T, Van Lieshout EMM, Verhofstad MHJ. Bennett fracture: Comparative study between open and closed surgical techniques. Hand Surg Rehabil. 2019 Apr;38(2):97-101. doi: 10.1016/j.hansur.2018.11.003. Epub 2019 Jan 9. PMID: 30639054. 12. Greeven APA, Van Groningen J, Schep NWL, Van Lieshout EMM, Verhofstad MHJ. Open reduction and internal fixation versus closed reduction and percutaneous fixation in the treatment of Bennett fractures: A systematic review. Injury. 2019 Aug;50(8):1470-1477. doi: 10.1016/j.injury.2019.06.027. Epub 2019 Jun 28. PMID: 31288938.


How to Cite this article: Navale VV, Gulati M | Comparison of Functional Outcome Between Trans– 2nd Metacarpal Fixation and Trans-Trapezius Fixation with K-Wire for Bennett Fracture | July-December 2021; 7(2): 01-03.

 


(Article Text HTML)   (Download PDF)