Operative Technique

ORIF Bennett’s Fracture

Aims

Indications

Contraindications

Consent / Preop Planning

• check subluxation which will be present
  • axial pressure should easily sublux it

Principles

Options

Position

• supine

Landmarks

Incision

• Dorsal 2 cm incision along ulnar border of 1st MC

Internervous Plane

Superficial Dissection

• retract APL
• being careful of nerves

Deep Dissection

• capsulotomy

Dangers

Procedure

• reduce fracture
  • it is difficult to see fracture because of ulnar position
    • suspensory ligament
  • reduce it with Howarth & press upwards
  • check reduction &
• 1.7 mm Leibinger screw
  • use correct drill & screw
  • NB Leibinger 1.2, 1.7, 2.3
  • 1.7 & 2.3 same guide
• Close in layers
  • Capsule with int 3.0 PDS
  • Skin with 5.0 nylon

Postop / Rehab

• Thumb spica
  • 2/52
  • thumb splint for 6/52

Results

Complications / Dangers

External Links