Management of Bennett's fracture: A systematic review and meta-analysis

BACKGROUND: First described in 1882, Bennett's fracture is an intra-articular fracture of the first metacarpal associated with a dislocation of the carpometacarpal joint. Usually, open reduction internal fixation is used to manage such fractures. However, closed reduction has shown good outcomes recently. This meta-analysis compares closed reduction to open reduction internal fixation in the management of Bennett's fracture. METHODS: PubMed, Cochrane, and Google Scholar (pages 1–20) were searched until August 2023. The clinical outcomes consisted of post-traumatic arthritis, grip and pinch strengths, range of motion, functional scores, and mean adduction deformity. RESULTS: Six retrospective studies were included in this meta-analysis. Our results show higher grip and pinch strengths, better extension and flexion of the thumb, and lower mean adduction deformity in the open reduction internal fixation group. CONCLUSION: Higher grip and pinch strengths, better extension and flexion of the carpometacarpal joint, and a smaller mean adduction deformity of the thumb in the open reduction internal fixation group. No differences were seen in the remaining outcomes. However, a higher rate of complications is associated with open reduction internal fixation. Nevertheless, more randomized controlled studies are needed to confirm such results. LEVEL OF EVIDENCE: III