Background: Bennett's fracture, a fracture-dislocation of the base of the first metacarpal, poses significant challenges due to the unique biomechanics of the thumb's carpometacarpal (CMC) joint. Effective management is critical to restoring thumb function and preventing long-term complications such as arthritis and instability.
Objective: This article provides a comprehensive overview of Bennett's fracture, including its mechanism of injury, diagnostic considerations, and management strategies, with a focus on conservative and surgical options.
Methods: A detailed review of the current literature was conducted to outline the principles and techniques of closed reduction with percutaneous pinning (CRPP), open reduction and internal fixation (ORIF), and emerging methods such as arthroscopic-assisted fixation.
Results: Conservative management is appropriate for minimally displaced fractures but is often inadequate for displaced injuries due to persistent muscle forces acting on the metacarpal. CRPP offers a minimally invasive option for fractures with moderate displacement, while ORIF provides superior stability for complex fractures. Emerging techniques, including arthroscopy and bioabsorbable implants, show promise in minimizing complications and improving outcomes.
Conclusion: The management of Bennett's fractures requires a tailored approach based on fracture displacement, patient needs, and surgeon expertise. Timely diagnosis, appropriate treatment selection, and structured rehabilitation are essential for optimal recovery. Advances in imaging, surgical methods, and materials hold the potential to further refine treatment strategies and improve long-term outcomes.