Objective: Treating high-level athletes involves a balance between early and safe return to play. Various types of protective immobilization have been recommended after operatively treated Bennett's fracture. The purpose of this study was to investigate if hand-based immobilization offers protection equivalent to forearm-based immobilization.
Materials And Methods: A cadaveric model of Bennett's fracture was created in 8 fresh-frozen, cadaveric forearms. Osteosynthesis was performed using a single headless compression screw. Three matched pairs were casted in either hand-based or forearm length, thumb spica casts, while 2 specimens remained un-casted as controls. Specimens were mounted on a custom testing apparatus. Weights were added in 6.8-kg increments until fixation failed and the fracture displaced. Fluoroscopy was performed after each trial. We used the Kruskal-Wallis non-parametric test to compare the groups. We considered <.05 statistically significant.
Results: Failure of fixation occurred at 6.8 kg in the control specimens. Fixation failed in hand-based and forearm length casts at a mean of 18.1±5.1 kg. We did not find a statistically significant difference between median values of load at failure in kilograms across control specimens and 2 immobilization categories (=.114). All specimens in the hand-based group sustained additional wrist injuries, while no additional injuries were noted in the forearm length group.
Conclusion: Our study results showed that hand-based immobilization provides equivalent protection against fixation failure for operatively treated Bennett's fractures but may predispose athletes to increased risk of wrist injury compared with traditional, forearm-based casting. [. 2024;47(3):157-160.].
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http://dx.doi.org/10.3928/01477447-20231220-03 | DOI Listing |
Cureus
December 2024
Department of Trauma and Orthopaedics, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, GBR.
Background This is a retrospective service evaluation of outcomes of polytrauma patients sustaining knee dislocations and subluxations within a major trauma center (MTC). Polytrauma patients with knee dislocations are complex to manage and often sustain multiple life-threatening injuries. Although treatments have progressed, no consensus remains on management timing and strategy.
View Article and Find Full Text PDFGeorgian Med News
October 2024
Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, United Kingdom.
Background: Bennett's fracture, a fracture-dislocation of the base of the first metacarpal, poses significant challenges due to the unique biomechanics of the thumb's carpometacarpal (CMC) joint. Effective management is critical to restoring thumb function and preventing long-term complications such as arthritis and instability.
Objective: This article provides a comprehensive overview of Bennett's fracture, including its mechanism of injury, diagnostic considerations, and management strategies, with a focus on conservative and surgical options.
Nat Rev Neurol
January 2025
Department of Neurology, University of Michigan, Ann Arbor, MI, USA.
Diabetic peripheral neuropathy (DPN) is length-dependent peripheral nerve damage arising as a complication of type 1 or type 2 diabetes in up to 50% of patients. DPN poses a substantial burden on patients, who can experience impaired gait and loss of balance, predisposing them to falls and fractures, and neuropathic pain, which is frequently difficult to treat and reduces quality of life. Advanced DPN can lead to diabetic foot ulcers and non-healing wounds that often necessitate lower-limb amputation.
View Article and Find Full Text PDFJ Shoulder Elbow Surg
December 2024
Medical University of South Carolina, 96 Jonathan Lucas Street CSB 708, MSC 622, Charleston, SC, 29425, USA. Electronic address:
Introduction: Frailty is an age-related state of multi-system decline that has been associated with negative outcomes after surgery. Numerous methods have been utilized to quantify frailty and predict postoperative outcomes with variable results. The purpose of this study is to determine if the Hospital Frailty Risk Score (HFRS) is an independent predictor of postoperative complications and increased healthcare costs following elective primary total shoulder arthroplasty (TSA).
View Article and Find Full Text PDFOrthop Traumatol Surg Res
October 2024
CHU Lille, Service d'Orthopédie-Traumatologie, Hôpital Roger Salengro, F-59000 Lille, France.
Introduction: The percutaneous pinning method described by Iselin is one of the techniques used for treating Bennett fractures at the base of the thumb metacarpal. There is little published data on the medium- and long-term outcomes of this treatment, with most studies having a mean follow-up of 4 years. The primary objective of this study was to evaluate the functional and radiological outcomes of percutaneous pinning by Iselin's method with a mean follow-up of 6 years.
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