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[Credit: Wikipedia](https://commons.wikimedia.org/wiki/File:BennettFracMark.png)

The five "metacarpals," or long bones, that make up the hand. These bones link the fingers' bones to the wrist's bones at the wrist. One metacarpal bone and two phalanges make up the thumb (proximal and distal).

The joint that connects the wrist's trapezium bone to the base of the metacarpal bone is known as the carpometacarpal joint.

Edward Hallaran Bennett is honored with the name of a Bennett's fracture or Bennett. The break, according to his initial description, was an intra-articular break at the base of the first metacarpal that extended all the way into the Carpometacarpal joint.

The Bennett's fracture is the most typical thumb fracture. The CMC joint, which allows the hand to grasp and pinch, is an extremely flexible joint.

Most broken bones at the base of the thumb are called Bennett fractures. This fracture is a break inside the joint that separates the palmar ulnar side of the base of the first metacarpal from the rest of the first metacarpal. Most of the time, the injury is caused by axial loading on a metacarpal that is partially bent. It may also be linked to other carpal bone fractures or ligament injuries.

Because these fractures are thought to be unstable, radiographs are extremely important for figuring out what happened and planning a surgery to fix them. Different kinds of surgery are used to fix these fractures. Both open reduction with pins or inter-fragment pinning and closed reduction with percutaneous pinning are possible. If the pieces of the broken bone are aligned well after surgery, the clinical outcome is usually good.

An axial stress on a partly flexed metacarpal causes this fracture, which can also cause damage to the ulnar collateral ligament of the thumb metacarpophalangeal joint and/or fractures of the neighboring carpal bone (trapezium).

## The abnormal stage
It has a characteristic fracture pattern. Because the frontal oblique ligament, which holds the palmar ulnar fragment of the first metacarpal to the trapezium during axial loading while the rest of the metacarpal moves in the opposite direction, creates the main fracture line along this point of weakness, the base of the first metacarpal is fractured with an intraarticular extension. Because of this fracture, the first metacarpal shaft subluxated dorsally, proximally, and radially. This happened because of the pull of the abductor pollicis longus, extensor pollicis longus, extensor pollicis brevis, and adductor pollicis brevis, which are still attached to the fracture fragment.


Pain and swelling at the base of the thumb are among the things that have been found.

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Source: [Wikipedia](https://commons.wikimedia.org/wiki/File:Fig_2..jpg)
    
Standard hand radiographs include views from the front to the back, side to side, and top to bottom. You can get more dedicated views of the thumb, like Robert's, to learn more about the injury. This is a true AP view of the first carpal-metacarpal joint. The forearm is turned inward, and the thumb's dorsal side is pressed against the radiographic plate. The x-ray beam is pointed 90 degrees to the plate. The Betts' view is another one. To get this view, the palm is turned 20 degrees away from being flat against the radiograph plate, and the beam is pointed 15 degrees from the proximal end to the distal end. By squeezing the radial aspects of the thumbs together on an AP view, stress radiographs can also be taken, which may show subluxation of the metacarpal base relative to the trapezium on the problematic side.

Gredda divided Bennett fractures into three varieties based on radiographic appearance, with type 1 being a fracture with a single ulnar fragment and metacarpal base subluxation, type 2 being an impaction fracture without metacarpal base subluxation, and type 3 being an injury with a minor ulnar avulsion fragment in conjunction with metacarpal dislocation.

### Medications / Methods of Administration
For a good reduction, you need to pull on the axilla, move the palm outward, turn the hand over, and put pressure on the base of the first metacarpal from the outside. It's best to avoid putting your thumb in the "hitchhiker position" when it's outstretched, since this has been shown to cause the fracture to move.

Since closed reduction and splinting were the most effective methods of treatment up until the 1970s, Bennett described how to treat these fractures in his initial publication. However, more recent studies have revealed that casting alone is not a useful technique to treat these sorts of fractures. Previously, this treatment was proven to be effective. Different types of surgery can be used to fix Bennett fractures, but usually one of two methods is used: closed reduction with percutaneous pinning or open reduction with pins or interfragmentary screws.

All methods of fixing anything are effective, as demonstrated by case studies and extensive research. Closed reduction with intermetacarpal fixation from the first to the second metacarpal and/or to the trapezium is the most common treatment for first metacarpal shaft subluxation. Most frequently, a Wagner incision is used for open reduction if it is decided to treat this fracture. Whether to use an open or closed reduction to treat these fractures is still up for discussion.

### References
Carter, K. R., & Nallamothu, S. V. (2022, August 8). Bennett Fracture, StatPearls, NCBI Bookshelf https://www.ncbi.nlm.nih.gov/books/NBK500035/#:~:text=Introduction-, StatPearls-NCBI Bookshelf. Bennett%20fracture%20is%20the%20most%20common%20fracture%20involving%20the%20base,from%20the%20remaining%20first%20metacarpal

Bennett’s Fracture: Break at the Base of Your Thumb. (n.d.) Jacksonville Orthopaedic Institute. https://www.joionline.net/trending/content/bennetts-fracture-break-base-your-thumb

Bennett’s fracture. (n.d.). Physiopedia. https://www.physio-pedia.com/Bennett%27s_fracture

Bennett’s fracture—Wikipedia (2022, September 8). Bennett’s Fracture (Wikipedia) https://en.wikipedia.org/wiki/Bennett%27s_fracture

MD, J. E. (2023, April 15). Base of thumb fractures; hand; orthobullets Base of thumb fractures; hand; orthobullets https://www.orthobullets.com/hand/6036/base-of-thumb-fractures
    
    
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