gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Long-term Patient Reported Functional Outcomes following Bennett’s Fracture Repair

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  • presenting/speaker Benjamin Langridge - Department of Plastic and Reconstructive Surgery, Royal Free London NHS Foundation Trust, London, United Kingdom
  • Michelle Griffin - Department of Plastic and Reconstructive Surgery, Royal Free London NHS Foundation Trust, London, United Kingdom
  • Mo Akhavani - Department of Plastic and Reconstructive Surgery, Royal Free London NHS Foundation Trust, London, United Kingdom
  • Peter Butler - Department of Plastic and Reconstructive Surgery, Royal Free London NHS Foundation Trust, London, United Kingdom

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1642

doi: 10.3205/19ifssh0785, urn:nbn:de:0183-19ifssh07851

Published: February 6, 2020

© 2020 Langridge et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: Optimal management of Bennett's fractures of the thumb are important for long term hand function. The current evidence base on the management of Bennett's fractures is limited due to the infrequency of this fracture. We present an 11-year retrospective analysis of Bennett's fracture fixation and patient reported outcome measures to identify long term functional outcomes and risk factors for suboptimal recovery.

Methods: We conducted a retrospective analysis of our centre's trauma database over an 11-year period to identify all patients with a Bennett's fracture who underwent surgical intervention. Electronic medical records were analysed to extract mechanism of injury, smoking status, comorbidities, complications, time to surgery, surgical fixation method and post-operative hand function. Patients were invited to complete a Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire to assess long term functional outcomes. Descriptive statistics were applied to characterise the patient cohort. Statistical analyses were conducted to identify risk factors for suboptimal functional recovery.

Results and Conclusions: A total 79 patients were identified over a 11-year period with a mean age of 31.7 years at time of injury (13 to 74), 18 were excluded. Mechanisms of injury reported were: sports injuries (31.1%), violence (24.6%), falls (18%), road traffic accidents (16.4%), occupational (4.9%) and other accidents (4.9%).

Of the 61 patients, 71% returned to unrestricted range of movement during hand therapy. 95% of cases were managed with K-wire insertion. 85% of cases were closed reduction. The post-operative complication rate was 14%. Of the 61 patients asked to complete a DASH questionnaire, 21 patients did not respond and 40 patients responded. The mean time since injury was 5.1 years (0.8 to 11.6 years). Of the 40 responders, the mean DASH score was 9.1 (1.7 to 69.2).

Long term patient reported functional outcomes in patients with Bennett's fractures requiring K-wire fixation are excellent. Post-operative complication rates are low and wound infections are uncommon. Age at time of fracture, smoking status and open fixation were not associated with inferior long term patient reported outcomes.