Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Aug 18, 2017; 8(8): 656-659
Published online Aug 18, 2017. doi: 10.5312/wjo.v8.i8.656
Bennett’s fracture associated with fracture of Trapezium - A rare injury of first carpo-metacarpal joint
Tarun Goyal
Tarun Goyal, Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh 248201, India
Author contributions: Goyal T conducted the study and compiled the report.
Institutional review board statement: Institutional review board approval granted from AIIMS Rishikesh.
Informed consent statement: Written informed consent taken from patient prior to inclusion.
Conflict-of-interest statement: Author declares that there is no conflict of interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Tarun Goyal, Assistant Professor, Department of Orthopaedics, All India Institute of Medical Sciences, Virbhadra Marg, Rishikesh 248201, India. goyal.tarun@gmail.com
Telephone: +91-847-5000283 Fax: +91-135-2462976
Received: July 14, 2016
Peer-review started: July 29, 2016
First decision: October 21, 2016
Revised: January 22, 2017
Accepted: February 18, 2017
Article in press: February 20, 2017
Published online: August 18, 2017
Processing time: 382 Days and 11.6 Hours
Abstract

Association of fracture of trapezium with Bennett’s fracture is very rare and makes reduction and stabilisation more difficult. We are reporting a rare case of Bennett’s fracture with fracture of the trapezium and subluxation of the carpo-metacarpal joint (CMC) joint. The patient was a 47-year-old school teacher who fell from his motorbike on his outstretched right dominant hand. Radiographs and computed tomography showed fracture of the trapezium with subluxation of the CMC joint, associated with Bennett’s fracture. Open reduction and internal fixation was carried out. Trapezium was reduced first and secured with a 2 mm diameter screw. Bennett’s fracture was then reduced and fixed with two per-cutaneously placed Kirchner’s wires. CMC was stabilised with per-cutaneous Kirchner’s wires. Latest follow up at 12 mo showed a healed fracture with good reduction of the CMC joint. Clinically patient had no pain and normal extension, abduction and opposition of the thumb. QuickDASH score was 3.9/100. Thus, fracture of trapezium associated with a Bennett’s fracture is a rare injury and if ignored it may lead to poor results. This injury is more challenging to manage than an isolated Bennett’s fracture as anatomical reduction of the trapezium with reduction of the first CMC is needed. Fracture of the trapezium should be fixed first as this will provide a stable base for reduction of the Bennett’s fracture.

Keywords: Bennett’s fracture; Carpo-metacarpal joint; Trapezium

Core tip: Association of fracture of the trapezium with Bennett’s fracture is very rare and makes reduction and stabilisation more difficult. We are reporting a rare case of Bennett’s fracture with fracture of the trapezium and subluxation of the carpo-metacarpal joint (CMC) joint, and describing a technique for successful reduction and stabilisation of these fractures. Trapezium should be reduced first and secured with a 2 mm diameter screw. Bennett’s fracture should then be reduced and fixed with two per-cutaneously placed Kirchner’s wires. CMC should be stabilised with per-cutaneous Kirchner’s wires. This is expected to result in good functional outcomes.