Diagnosis

Bennett's Fracture: Type III

The diagnosis in this case was Bennett's fracture, type III, an oblique intraarticular fracture dislocation of the basal joint of the thumb metacarpal. The most common mode of injury is a motorcycle or bicycle accident, forcing the handlebar into the web space between the thumb and index finger. Other common causes include fights, sporting accidents, and falls on an outstretched hand. Generally, any trauma causing abduction and hyperextension of the thumb can cause a Bennett's fracture. Most of the injuries (70-90%) occur in men, and the peak age incidence is 35 to 45 years. A classification scheme for Bennett's fracture has been devised (Table 52-1).

Table 52-1 Classification of Bennett's Fracture Fracture Type Description

Type I Distal fragment separation with preservation of continuity of the proximal joint surface Type II The opposite of type I, with proximal fragment separation, joint surface disruption, and preservation of the distal cortex Type III Most common (67% incidence), with total separation of the fragment

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