title: Closed reduction external fixator fixation versus open reduction internal fixation in the patients with Bennett fracture dislocation.
abstract: BACKGROUND
  The Bennett fracture is either a common or a challenging problem to hand surgeons. It is still debated whether closed or open reduction gives optimal results. This study aimed to describe and assess a closed reduction and mini-external fixator fixation technique for the treatment of Bennett's fracture dislocation and to compare this technique versus open reduction and internal fixation.
  
  
  METHODS
  From October 2002 to December 2012, 56 patients with Bennett's fracture dislocation were treated by closed reduction and mini-external fixator fixation and 32 patients were treated by open reduction and internal fixation in Jishuitan Hospital. Patients with an articular step-off of more than 1 mm were excluded. All patients were assessed at a mean follow-up of 7 years (range 2-10 years) and the two groups were compared with pain levels, active range of trapeziometacarpal motion, grip strength and pinch strength, arthritic changes, and adduction deformity.
  
  
  RESULTS
  Based on primary closed reduction maintained , the rate of anatomic reduction is 63.6%. Radiographic fracture union was achieved in all patients at a mean time of 5 weeks. At the final follow-up, there was no difference between the two groups in mean union time and pain levels (P = 0.2). There was also no difference between the two groups regarding the active range of trapeziometacarpal motion (P = 0.3), grip stength (P = 0.6), pinch strength (P = 0.2), arthritic change and loss of reduction (P = 0.2). There was a significant correlation between adduction deformity and the development of arthritis (P = 0.02).
  
  
  CONCLUSIONS
  Closed reduction mini-external fixator fixation should be first tried to apply in the treatment of Bennett's fracture dislocation, and open reduction internal fixation should only be performed for irreducible fractures.
authors.affiliation: Department of Hand Surgery, Beijing Jishuitan Hospital, Beijing 100035, China.
authors.forename: Zhongzhe
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Hand Surgery, Beijing Jishuitan Hospital, Beijing 100035, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Guo
authors.affiliation: Department of Hand Surgery, Beijing Jishuitan Hospital, Beijing 100035, China. Email: wentiansyz@hotmail.com.
authors.forename: Wen
authors.initials: W
authors.lastname: Tian
authors.affiliation: Department of Hand Surgery, Beijing Jishuitan Hospital, Beijing 100035, China.
authors.forename: Guanglei
authors.initials: G
authors.lastname: Tian
mesh_terms: D000328:Adult; D001168:Arthritis / Q000601:surgery*; D016267:External Fixators; D005260:Female; D005592:Fracture Fixation / Q000379:methods*; D005593:Fracture Fixation, Internal / Q000379:methods*; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male