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Bennett fracture: with subsequent complication

Case contributed by Chris O'Donnell
Diagnosis certain

Presentation

Bent thumb back. Sustained a Bennett fracture at the base of first metacarpal. Treated surgically with 2 K-wires. Now 12 months later severe pain at the base of the thumb.

Patient Data

Age: 20 years
Gender: Male

Typical oblique fracture at the base of the 1st metacarpal with displacement and extension into the joint (first image). Fracture pinned (second image) and united with slight malalignment (third image one year later).

Findings of osteoarthritis with small osteophytes, bone marrow edema on either side of the joint, small subarticular cysts and joint fluid. Articular cartilage is irregular in contour.

Case Discussion

This case highlights the importance of accurate reduction and fixation of Bennett fractures as they can go on to rapid premature osteoarthritis due to articular surface incongruity.

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