BENNETT CHANGE

From Big Medical Encyclopedia

BENNETT CHANGE (E.H. Bennett, 1837 — 1907, the Irish surgeon) — an intra joint change of the basis of the I metacarpal bone with an incomplete dislocation of her body in the back and beam party. It is described in 1882 by Bennett. The bp makes about 5% of all fractures of bones of a brush and 30% of fractures of metacarpal bones.

There is B. of the item more often owing to blow to a head of the I metacarpal bone, falling on the straightened I finger in a condition of its reduction. At the same time there is a longitudinal change at palmar and elbow edge of a joint surface of the basis of the I metacarpal bone. The broken-away small fragment in the form of a pyramid is kept on site by strong sheaves, and the metacarpal bone under the influence of the injuring force and a tension of sinews of a razgibately and long abductor is displaced along the joint surface of a big polygonal bone in the proximal direction, forming a back and beam incomplete dislocation.

Fig. Bennett's (roentgenogram) change.

Clinical signs of B. of the item. Bruise, deformation in the area I of a pyastnozapyastny joint with a vystupaniye of the basis of a metacarpal bone are observed. The I finger is in a condition of reduction, is shortened, the active and passive movements are limited, painful. Sharp morbidity at effleurage on a head of the I metacarpal bone or a finger-tip is noted. The bp should differentiate from a bruise and dislocation of the I metacarpal bone. The final diagnosis is made on the basis of given to a X-ray analysis (fig.) which allow to define a type of a change and degree of shift of fragments.

Treatment The bp consists in reposition with elimination of an incomplete dislocation of 1 metacarpal bone and deduction of fragments in the correct situation before consolidation. Reposition 5 ml vnutrisustavno carry out under local anesthesia 2% solution of novocaine. Make extension for the I finger in the provision of assignment and simultaneous pressure upon the basis of 1 metacarpal bone from a dorsum. After reposition apply plaster a bandage in the provision of the maximum assignment of the I finger. Stronger deduction of fragments is reached by fixing by 2 spokes — one is carried out through both fragments, and another — in the slanting direction through metaphyses of I and II metacarpal bones. An immobilization approximately within 1 month, further — massage, bathtubs, gymnastics. Working capacity is recovered at the correct treatment in 1 — 1,5 month. The wrong treatment leads to development of the deforming arthrosis and falloff of operability of a brush.

Bibliography:

Bogdanov B. A. and Malkis A. I. Use compression distraktsionnogo the device at treatment of changes of Bennet, Surgery, A5 4, page 111, 19T2, bibliogr.; B oymsv B., etc. Surgery of a brush and fingers, the lane with bolg., page 150, Sofia, 1971; Vasilkova K. I. To a technique of reposition of a fracture dislocation of the I metacarpal bone, the Works Le-ningr. nauch. - issled. in-that travmat. and shouting top., century 5, page 210, 1956, bibliogr.; Watson-Jones R. Fractures of bones and injury of joints, the lane with English, page 398, M., 1972; At E. V soltsev. Damage of a brush, D., 1961, bibliogr.; Chabou Nin A. V. Mechanism, clinic and treatment of changes of Bennet, Orton, and travmat., 34 * 11, page 52, 1964, bibliogr.; Bcnnett E.H. Fractures of the metacarpal bones, Dublin J. med. Sei., v. 73, p. 72, 1882; Moegk of E. Dringliche Handchirurgie, Stuttgart, 1964; Thordn L. A new method of extension treatment in Bennett’s fracture, Acta chir. scand., v. 110, p. 485, 1956, bibliogr.; Troian E. Traitement des fractures instables de la main et des doigts, Rev. Chir. orthop., t. 48, p., 269, 1962.

E. Ya. Dubrov.

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