Neglected Bennett Fracture: An Expanded Approach.
Renata Vaz, Pedro Martins Branco, Paulo Rego et al.
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Case in brief
Two male manual workers, aged 24 and 43 years, presented with thumb-base pain 4 to 6 months after trauma. Radiographs and computed tomography showed Bennett fracture nonunion with subluxation of the first metacarpal base. Both underwent small-fragment excision and suture button suspension using the Mini TightRope technique, followed by brief immobilization and progressive hand therapy. At 5 months, both had thumb motion similar to presurgery levels, improved pain scores and pinch and grip strength, with satisfactory radiographic positioning and healing. One resumed all activities at 3 weeks; the other took 5 months after a conservatively managed second metacarpal fracture.
What made this case unusual
The report describes suture button suspension with fragment excision for neglected Bennett fracture nonunion, a technique the authors state had not previously been reported for this lesion.
Diagnostic / clinical pearl
In persistent thumb-base pain months after trauma, imaging can identify Bennett fracture nonunion and first-metacarpal subluxation; this report describes fragment excision with suture button suspension as a possible approach when advanced arthritis is absent.
Why it matters
The two cases had improved pain scores and pinch and grip strength, but the authors note that further research is needed to assess long-term efficacy and safety.