Bennett's fracture: a direct volar surgical approach

Abstract

From cadaver dissections of the recurrent motor branch of the median nerve, we determined the exact relationship of its terminal branches at the base of the thumb. This enabled us to surgically approach the first carpometacarpal joint directly on the aspect for management of Bennett's fractures in 18 consecutive patients. As compared with the different surgical approaches advocated and commonly used, the direct volar approach affords clear direct exposure of the intra-articular fracture at the base of the thumb so aiding appropriate reduction and fixation of the fracture. The proposed approach is safe and requires minimal dissection or soft tissue resection. The results were excellent and no case of nerve injury was encountered.