Hand Fractures

Classification

It is important to distinguish the intra-articular fractures (Type I [Bennett's] + II [Rolando's]) from the extra-articular (III + IV) fractures, as the extra-articular fractures can be managed adequately with non-operative management

Up to 30° of angulation of the 1^st metacarpal base can be accommodated due the large ROM at the trapezio-metacarpal joint

Bennett's Fracture

•  A fracture-dislocation, first described by Bennett in 1882

• Mechanism of injury is an axial blow directed against the partially flexed metacarpal

• Fracture line separates the major part of the metacarpal from a small volar lip fragment, producing disruption of the CMC joint

• An avulsion fracture occurs rather than a pure dislocation because of the strength of the anterior oblique ligament (AOL)