Base of thumb fractures: a review of anatomy, classification, and management
Younis, Zubair Hamid, Muhammad A Devasia, Thomas Khan, Muhammad Murtaza Abdullah, Faliq Singh, Rohit Simons, Adrian William
Younis, Zubair
Hamid, Muhammad A
Devasia, Thomas
Khan, Muhammad Murtaza
Abdullah, Faliq
Singh, Rohit
Simons, Adrian William
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Publication date
2025-01-01
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Abstract
Fractures of the thumb metacarpal base are uncommon but significant due to their critical role in hand functionality and hand grip strength. These fractures exhibit diverse patterns, including extra-articular, Bennett, Rolando, and highly comminuted fractures, each with unique implications for management and outcomes. Each type presents unique challenges in achieving anatomical reduction, stability, and favorable long-term outcomes. This review explores the anatomy of the trapeziometacarpal joint, classification systems, clinical presentation, imaging techniques, and management strategies for these fractures. Stable extra-articular fractures often respond well to closed reduction and casting, while displaced intra-articular fractures generally require surgical intervention. Bennett fractures are typically treated using closed reduction and percutaneous pinning or open reduction and internal fixation. Rolando and comminuted fractures pose greater challenges due to their inherent instability and often necessitate advanced techniques such as locking plates, external fixation, or arthroscopic-assisted procedures. Achieving anatomical reduction is paramount to prevent complications such as joint incongruity, instability, and post-traumatic arthritis. Optimal treatment approaches depend on fracture patterns, stability, and patient-specific factors, with surgical techniques tailored to preserve thumb function and minimize long-term morbidity.
Citation
Younis Z, Hamid MA, Devasia T, Khan MM, Abdullah F, Singh R, Simons AW. Base of Thumb Fractures: A Review of Anatomy, Classification, and Management. Cureus. 2025 Jan 1;17(1):e76729. doi: 10.7759/cureus.76729.
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Article