Minimally Invasive Screw Fixation in Bennett Fractures: A New Reposition Technique in a Case Series.

Abstract

Transfixation or open reduction are conventional methods for treating Bennett fractures, with no current gold standard. Transfixation only allows for insufficient reduction, while the open approach by Wagner is relatively invasive. We present a minimally invasive surgical approach that allows anatomical reduction and short operation time. We report previous experiences in a case series of five patients. The disabilities of arm, shoulder, and hand score, visual analog scale, range of motion of the thumb, grip, and pinch strength were used for assessing the outcomes. Closed reduction employs an additional K-wire drilled through the ulnar base of metacarpal 2 into the Bennett fragment or into the oblique posteromedial ligament, followed by fixation with 2 cannulated compression screws. By the new technique, anatomical reduction and fixation of the Bennett fragment can be achieved minimally invasive. Previous interventions demonstrated good clinical, radiographic, and patient-reported outcomes after 6 months. In conclusion, minimally invasive screw fixation in Bennett fractures, coupled with repositioning using an additional guide wire, combines the advantages of allowing anatomical reduction and a less invasive approach seen in established methods.