66 Closed Reduction and Internal Fixation of Bennett’s or Rolando’s Fractures

Base of the thumb metacarpal fracture with displacement or joint subluxation or both (Fig. 66-1)

Technique

• Regional anesthesia with intravenous sedation
  
• Fracture reduction with longitudinal traction, adduction of the thumb metacarpal base (i.e., abduction of the metacarpal head), and pronation of the thumb ray (Fig. 66-2)
  
• Direct pressure to the thumb metacarpal base toward the avulsion fracture (Bennett’s fracture) facilitates reduction.
  
• Main focus is to reduce metacarpal subluxation and restore articular congruity to within 1 mm.
  
• Reduction verified using minifluoroscopy.
  
• Percutaneous fixation with two 0.45 in. (1.1 mm) trocar-tipped wires drilled through the thumb metacarpal and into the index metacarpal or carpus (Fig. 66-3).
  
• The ends of the wires can be left outside the skin or cut beneath the skin.

Figure 66-1

Figure 66-2

Related posts:

Intra-articular Fractures of the Distal Radius Treated with Dorsal Plate Resect Ulnar Styloid Fracture with Repair of Triangular Fibrocartilage Complex Sauve-Kapandji Procedure Darrach Procedure (Distal Ulna Resection) Scaphocapitate Fusion with Lunate Excision Capitate Shortening with Capitohamate Fusion

Stay updated, free articles. Join our Telegram channel

Join