The Archives of Bone and Joint Surgery

The Archives of Bone and Joint Surgery

Outcomes of Patients with Bennett Fracture Treated with Three Different Surgical Techniques: A Systematic Review

Document Type : SYSTEMATIC REVIEW

Authors
Eduardo Velásquez-Girón
Edna Rocío Buitrago-Quiñonez
Jorge Hernánez-Guevara
Álvaro Antonio Kafury
Division of Hand Surgery, Pontificia Universidad Javeriana, Cali, Colombia
10.22038/abjs.2024.81116.3702
Abstract
Objectives: Bennett's fracture, the most common intra-articular fracture occurring at the base of the 
thumb, accounts for less than 1% of all hand fractures. It typically results from specific traumatic 
mechanisms, deforming forces, and ligamentous injuries. To compare the functional outcomes and 
sequelae in patients with Bennett's fracture treated surgically using: Open reduction and internal screw 
fixation, closed reduction and percutaneous fixation, arthroscopy-assisted reduction and screw fixation.
Methods: A systematic literature review was conducted to identify studies on Bennett's fracture dislocations in 
patients over 18 years of age without additional injuries. Searches were performed in PubMed, Scopus, Cochrane 
Central, Web of Science, Scielo, Lilacs, Oneme, and Epistemonikos databases, with language restrictions in 
English, French, Spanish, Portuguese, Italian, and German, and no date restrictions. Primary outcome variables 
included measures of functionality and secondary outcomes such as pain, stiffness, and osteoarthritis.
Results: A total of 18 studies met the selection criteria, with most being retrospective (94.45%). Pain measures 
were reported in 77.78% of the studies, predominantly using the VAS (min=0 and max=2). All techniques seemed 
to achieve similar functional outcomes. The main difference was the pain registered at follow-up, mainly by patients 
treated with open reduction. Osteoarthritis appeared as a common consequence of these fractures, regardless of 
the treatment type -excluding arthroscopy-assisted reduction as there was not enough data.
Conclusion: The three techniques had similar functional outcomes. Closed reduction and percutaneous fixation 
appear to result in less pain; however, both closed reduction with percutaneous fixation and open reduction with 
internal screw fixation have similar rates of osteoarthritis at follow-up. Unfortunately, there is insufficient data to 
evaluate arthroscopy-assisted reduction with screw fixation, suggesting the need for rigorous follow-up in patients 
undergoing this surgical intervention.
 Level of evidence: III
Keywords
Bennett's fracture
First metacarpal
Functionality
Hand
Pain
Surgery
Subjects
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The Archives of Bone and Joint Surgery
Volume 13, Issue 1
January 2025
Pages 4-16

  • Receive Date 15 July 2024
  • Revise Date 05 November 2024
  • Accept Date 06 November 2024