gms | German Medical Science

Objectives/Interrogation: To introduce a tension band wiring technique for the treatment of Bennett fractures through a small incision, which allows early motion of the first carpometacarpal joint.

Methods: From January 2015 to May 2017, 32 Bennett fractures in 32 patients were treated with open tension band wiring. The mean age of the patients was 34 years (range, 20 to 52 years). There were 30 male and 2 female patients. There were 31 dominant hands and 1 nondominant hand. The mean time between the injury and operation was 7 days. The average joint surface involvement was 41%. All injuries were associated with carpometacarpal joint subluxation. We prefer a small dorsal incision 0.5 cm in length. The volar fragment was fixed to the first metacarpal with tension band wiring. Joint motion was started 2 days after surgery. At the final follow-up, motion of the thumbs and pinch and grip strength of the hands were assessed-

Results and Conclusions: No fixation failure was noted. Radiographic fracture healing was attained in all patients at an average period of 4 weeks. Patient follow-up lasted 26 months (rang, 24 to 29 months). At the final follow-up, the mean extension-flexion arc of the first carpometacarpal joint was 46° (range, 39° to 52°). The mean thumb abduction was 85°(range, 75° to 93°) and mean pinch and grip strength of the injured hands were 7.2 kg (range, 4.6 kg to 9.3 kg) and 47 kg (range, 32 kg to 52 kg), respectively. The measurements were similar to those on the opposite side. There were no significant differences between two groups regarding the extension-flexion arc of the first carpometacarpal joint and grip strength (p>0.05). The two groups were similar regarding thumb abduction and pinch strength (p>0.05).

Open tension band wiring through a small incision is a minimally invasive technique that is reliable and presents another fixation option for the treatment of Bennett fractures.