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Bennett's Fracture ORIF 26665

Bennetts Fracture xray Bennetts fracture anatomy 

 

CPT Coding Technique
Indications Complications
Contraindications Follow-up Care / Rehab Protocol
Alternatives Outcomes
Pre-op Planning / Case Card Review References

synonyms:Bennett fracture, thumb fracture, thumb metacarpal fracture ORIF

 Bennett Fractrue ORIF CPT

Bennett Fractrue ORIF Indications

  • Bennett fragment < 20% of the articular surface: CRPP
  • Bennett fragment>20% of the articular surface:ORIF

 Bennett Fractrue ORIF Contraindications

  • Underlying advanced arthritis.  
  • Medically unstable
  • Active infection

Bennett Fractrue ORIF Alternatives

  • Closed treatment

Bennett Fractrue ORIF Pre-op Planning

  • Ensure appropriate K-wires, plate and screws are available. 
  • Generally 2.0 or 2.7mm screws or 

Bennett Fractrue ORIF Technique

  • Sign operative site.
  • Pre-operative antibiotics
  • Bier block / regional block.
  • Supine position. All bony prominences well padded.
  • tourniquet
  • Prep and drape in standard sterile fashion.
  • For < 20% of the articular surface involvment:  reduce the fracture by extending and pronating the metacarpal with longitudinal traction and downward pressure applied to the metacarpal base.  Drill K-wire obliquely across the thumb trapeziometacarpal joint while the the fracture.
  • Wagner incision between the abductor pollicis longus and the thenar muscles, extended proximally and radially to the radial border of the flexor carpi radialis. 
  • Reflect thenar muscles subperiosteally, incise joint capsule. 
  • Debride hematoma from Fracture site. 
  • Reduce Fracture. Fix with 2.0- or 2.7-mm lag screw.
  • Close in layers. 
  • Place in Thumb spica splint.

Bennett Fractrue ORIF Complications

Bennett Fractrue ORIF Follow-up care

  • Post-op: Thumb spica splint, elevation, NWB
  • 7-10 Days: Wound check, Thumb spica cast
  • 6 Weeks: K-wire removal, begin ROM exercises provided union is evident on xray.
  • 3 Months: Evaluated ROM. Sport specific rehab.
  • 6 Months:
  • 1Yr: f/u xrays, Assess outcome.

Bennett Fractrue ORIF Outcomes


Bennett Fractrue ORIF Review References

  • Rivlin M, Fei W, Mudgal CS. Bennett Fracture. J Hand Surg Am. 2015 Aug;40(8):1667-8. doi: 10.1016/j.jhsa.2015.05.017. Epub 2015 Jul 3.
  • Carlsen BT, Moran SL. Thumb trauma: Bennett fractures, Rolando fractures, and ulnar collateral ligament injuries. J Hand Surg Am. 2009 May-Jun;34(5):945-52.
  • Soyer AD. Fractures of the base of the first metacarpal: current treatment options. J Am Acad Orthop Surg. 1999 Nov-Dec;7(6):403-12.
  • Greens Hand Surgery(link is external)
  • Howard, CORR 220:46;1987
  • Rockwood and Green's Fractures in Adults 6th ed, 2006

 

 

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