Fractures of the thumb metacarpal base

A variety of fractures can occur at the thumb metacarpal base, which classically result from axial loading through a partially flexed thumb. Thumb base fractures account for 4% of all hand fractures [ [1] Stanton J.S. Dias J.J. Burke F.D. Fractures of the tubular bones of the hand. J Hand Surg Eur. 2007; 32: 626-636 Crossref Google Scholar ] and may occur in association with fractures of the trapezium [ [2] Garcia-Elias M. Henriquez-Lluch A. Rossignani P. et al. Bennett's fracture, combined with fracture of the trapezium, a report of three cases. J Hand Surg Br. 1993; 198: 523-526 Crossref Scopus (22) Google Scholar ], especially in men [ [3] McGuigan F.X. Culp R.W... Surgical treatment of intra-articular fractures of the trapezium. J Hand Surg Am. 2002; 27: 697-703 Abstract Full Text Full Text PDF PubMed Scopus (37) Google Scholar ]. Displaced intra-articular fractures include the eponymous patterns described by Edward Bennett [ [4] Bennett E.H... Fractures of the metacarpal bones. Dublin J Med Sci. 1882; 73: 72-75 Google Scholar ] and Silvio Rolando [ [5] Rolando S... Fracture de la base du premier metacarpien et principalement sur une variété non encore écrite. Presse Med. 1910; 18: 303 Google Scholar ], in addition to more comminuted variants. These intra-articular fractures are unstable, with important implications for their management. Bennett fractures account for 30% of all thumb metacarpal fractures [ [6] Hove L.M... Fractures of the hand. Distribution and relative incidence. Scand J Plast Reconstr Surg Hand Surg. 1993; 27: 317-319 Crossref PubMed Scopus (116) Google Scholar ] and occur four times more frequently than the Rolando fracture [ [7] Gedda K.O... Studies on Bennett's fracture; anatomy, roentgenology, and therapy. Acta Chir Scand Suppl. 1954; 193: 1-114 PubMed Google Scholar ]. Extra-articular fractures are common, typically occurring at the metaphyseal-diaphyseal junction, and are often termed epibasal fractures.