Fractures of the basal joint of the thumb

Abstract

The two important fractures of the trapeziometacarpal joint are Bennett's fracture and Rolando's fracture. Bennett's fracture is a fracture-dislocation of the joint. The preferred treatment is closed reduction and percutaneous pinning of the fracture with additional fixation through the trapeziometacarpal joint verified by anteroposterior (AP) and lateral roentgenograms. If the fracture is not reducible, and open reduction through the thenar approach with Herbert screw fixation is recommended. Rolando's fracture is a comminuted T- or Y-shaped fracture through the base of the first metacarpal. The preferred treatment is an external fixator accompanied by the tension band wiring technique.