Cassaro Salvatore, Ratano Salvatore, Cobisi Domenico Claudio, Salomone Gabriele, Ferruzza Massimo, Camarda Lawrence
Department of Orthopaedics Surgery (DICHIRINOS), University of Palermo, Palermo, Italy.
Trauma Case Rep. 2023 Feb 7;44:100786. doi: 10.1016/j.tcr.2023.100786. eCollection 2023 Apr.
Bennet's fracture represents one of the most common injuries of the hand district, involving the base of the thumb, and it is affects children and elderly patients the most. The fracture is caused by direct axial trauma to a partially flexed first metacarpal and it is always intra-articular: the fracture line separates the palmar ulnar aspect of the first metacarpal base from the remaining first metacarpal. The fracture pattern is such that the first metacarpal shaft moves dorsally, proximally, and radially due to the pull of the abductor pollicis longus, extensor pollicis longus, extensor pollicis brevis, and the adductor pollicis brevis, which remain attached to the fracture fragment. The surgical treatment consists of closed reduction with percutaneous pinning or open reduction with either pins or interfragmentary screws. The decision to treat these fractures with either open reduction or closed reduction is still a matter of debate. To the best of our knowledge, there are no cases of bilateral Bennett's fracture reported in literature. The aim of this paper is to present a rare case of bilateral Bennet's fracture, the decision of two different treatments, and the good clinical outcomes.
本内特骨折是手部最常见的损伤之一,累及拇指基部,且最常影响儿童和老年患者。该骨折由部分屈曲的第一掌骨受到直接轴向创伤引起,且总是关节内骨折:骨折线将第一掌骨基部的掌侧尺侧部分与其余第一掌骨分开。骨折类型使得第一掌骨干由于拇长展肌、拇长伸肌、拇短伸肌和拇短内收肌的牵拉而向背侧、近端和桡侧移位,这些肌肉仍附着于骨折碎片。手术治疗包括经皮穿针闭合复位或用钢针或骨折块间螺钉切开复位。采用切开复位还是闭合复位治疗这些骨折的决定仍存在争议。据我们所知,文献中未报道过双侧本内特骨折的病例。本文旨在介绍一例罕见的双侧本内特骨折病例、两种不同治疗方法的决策以及良好的临床结果。