A 30-year-old male presented to the emergency department with right hand pain after punching a brick wall. He has a history of Hepatitis C and heavy alcohol use. On examination, he had tenderness and swelling over the first metacarpal bone. X-rays revealed a Bennett fracture, an intra-articular fracture of the base of the first metacarpal with a triangular fragment. The fracture was treated with closed reduction, thumb traction, and splinting. He was referred to an orthopedist for follow up.

2.  HPI- 30 y/o male presents to the ED c/o right hand
pain after punching a brick wall.
PMX- Hep C
PSX- none
Allergies- nkda
Social- Heavy ETOH use

3.  Vitals- P- 82 BP 125/75 RR- 16 T- 98.6
 HEENT- NCAT
 EXT- Distal Pulses intact. Tenderness and swelling
noted over the 1st metacarpal

6.  Bennett Fracture
An intra- articular fracture/ dislocation of the base of
the first metacarpal.
An oblique fx line with a triangular fragment at the
ulnar base

7.  Closed Reduction
 Thumb Traction with metacarpal extension, pronation,
and abduction. Direct downward pressure to radial
metacarpal base
 Note: strong pull from APL frequently leads to
displacement.
 Thumb Spica Splint
 Ortho Follow up (Hand)

8.  Mechanism-
 Axial blow directed against the partially
flexed metacarpal
 History
 most frequent of all thumb frx;
- described in 1882 by Dr Edward Bennet
 Surgical Treatment
 Indicated if more than one mm of articular incongruity
or persistent CMC joint subluxation