The Archives of Bone and Joint Surgery

The Archives of Bone and Joint Surgery

Clinical Insights and Management of Pediatric Bennett-Equivalent Fractures: Case Report and Literature Review

Document Type : CASE REPORT

Authors
Daniel A. Nemirov
Pedro K. Beredjiklian
Greg G. Gallant
Rothman Orthopaedic Institute. Philadelphia, Pennsylvania, USA
10.22038/abjs.2025.86413.3929
Abstract
Pediatric Bennett-equivalent type fractures represent an uncommon yet consequential source of morbidity and diagnostic complexity. Despite the remarkable remodeling potential and resiliency of the pediatric patient population, if managed inappropriately, these injuries are associated with multiple sequelae such as residual deformity, pain, functional limitations, and prospective accelerated arthrosis. Given the paucity of literature and absence of prospective, rigorous trials, the optimal management of these injuries remains contentious. The present study exhibits the authors’ experience with two pediatric Bennett-equivalent fractures, one managed conservatively and one operatively, highlighting the necessity for provider vigilance and attentiveness in recognizing and treating these injuries. 
        Level of evidence: IV
Keywords
Bennett fractures
Hand
Injury
Management
Pediatric
Subjects
  1. Hastings H, Simmons BP. Hand fractures in children. A statistical analysis. Clin Orthop Relat Res. 1984;(188):120-130.
  2. Kluwer W. Fractures and dislocations of the hand and carpal bones in children. In: Rockwood and Wilkins’ Fractures in Children. 9th ed. Water PM, Skaggs DL, Flynn JM, eds. Lippincott Williams & Wilkins; 2020.
  3. Mahabir RC, Kazemi AR, Cannon WG, Courtemanche DJ. Pediatric hand fractures: a review. Pediatr Emerg Care. 2001;17(3):153-156. doi:10.1097/00006565-200106000-00001.
  4. Liao JCY, Chong AKS. Pediatric Hand and Wrist Fractures. Clin Plast Surg. 2019;46(3):425-436. doi: 10.1016/j.cps.2019.02.012.
  5. Dial WB, Berg E. Bennett’s fracture. Hand. 1972;4(3):229-235. doi:10.1016/S0072-968X(72)80006-8.

 

  1. Rivlin M, Fei W, Mudgal CS. Bennett Fracture. J Hand Surg Am. 2015;40(8):1667-8. doi: 10.1016/j.jhsa.2015.05.017.
  2. Leclère FMP, Jenzer A, Hüsler R, et al. 7-year follow-up after open reduction and internal screw fixation in Bennett fractures. Arch Orthop Trauma Surg. 2012;132(7):1045-51. doi: 10.1007/s00402-012-1499-2.
  3. Lutz M, Sailer R, Zimmermann R, Gabl M, Ulmer H, Pechlaner S. Closed reduction transarticular Kirschner wire fixation versus open reduction internal fixation in the treatment of Bennett’s fracture dislocation. J Hand Surg Br. 2003;28(2):142-147. doi:10.1016/s0266-7681(02)00307-8.
  4. Goru P, Haque S, Verma GG, Mustafa A, Ebinesan A. Bennett’s Fracture Management: A Systematic Review of Literature. Cureus. 2022;14(11):e31340. doi:10.7759/cureus.31340.
  5. Kamphuis SJM, Greeven APA, Kleinveld S, Gosens T, Van Lieshout EMM, Verhofstad MHJ. Bennett’s fracture: Comparative study between open and closed surgical techniques. Hand Surg Rehabil. 2019;38(2):97-101. doi:10.1016/j.hansur.2018.11.003.
  6. Langridge B, Griffin M, Akhavani M, Butler PE. Bennett’s Fracture Repair-Which Method Results in the Best Functional Outcome? A Retrospective Cohort Analysis and Systematic Literature Review of Patient-Reported Functional Outcomes. J Hand Microsurg. 2021;13(2):81-88. doi:10.1055/s-0040-1703412.
  7. Levy V, Mazzola M, Gonzalez M. Intra-Articular Fracture of the Base of the First Metacarpal Bone: Treatment Through a Volar Approach. Hand (N Y). 2018;13(1):90-94. doi:10.1177/1558944716685828.
  8. Daher M, Roukoz S, Ghoul A, Tarchichi J, Aoun M, Sebaaly A. Management of Bennett’s fracture: A systematic review and meta-analysis. JPRAS Open. 2023;38:206-216. doi:10.1016/j.jpra.2023.09.010.
  9. Middleton SD, McNiven N, Griffin EJ, Anakwe RE, Oliver CW. Long-term patient-reported outcomes following Bennett’s fractures. Bone Joint J. 2015;97-B(7):1004-1006. doi:10.1302/0301-620X.97B7.35493.
  10. Griffiths JC. Bennett’s fracture in childhood. Br J Clin Pract. 1966;20(11):582-583.
  11. Gedda KO. Studies on Bennett’s fracture; anatomy, roentgenology, and therapy. Acta Chir Scand Suppl. 1954;193:1-114.
  12. Chew EM, Chong AKS. Hand fractures in children: epidemiology and misdiagnosis in a tertiary referral hospital. J Hand Surg Am. 2012;37(8):1684-1688. doi:10.1016/j.jhsa.2012.05.010.
  13. Brüske J, Bednarski M, Niedźwiedź Z, Zyluk A, Grzeszewski S. The results of operative treatment of fractures of the thumb metacarpal base. Acta Orthop Belg. 2001;67(4):368-373.
  14. van Niekerk JLM, Ouwens R. Fractures of the base of the first metacarpal bone: results of surgical treatment. Injury. 1989;20(6):359-362. doi:10.1016/0020-1383(89)90014-4.
  15. Qiao F, Shang X, Jiang F. Open vs. closed reduction with pinning for displaced Rockwood and Wilkins’ type C thumb metacarpal base fractures in children. Front Pediatr. 2024:12:1394853. doi: 10.3389/fped.2024.1394853.

 

 

The Archives of Bone and Joint Surgery
Volume 13, Issue 8
August 2025
Pages 526-531

  • Receive Date 28 February 2025
  • Revise Date 14 May 2025
  • Accept Date 17 May 2025