Soner Kocak, Cemil Ertürk
Cerrahpaşa Medical Journal - 2026;50(1):1-6
Objective: The optimal management of Bennett fractures remains controversial, with percutaneous fixation providing superior outcomes compared with immobilization alone. This study compared closed reduction followed by thumb spica short-arm casting (CR-TSC) with closed reduction and percutaneous Kirschner wire (PKW) fixation in adult patients. Methods: This retrospective comparative cohort study included adult patients treated for Bennett fractures between 2015 and 2024. Outcomes were assessed using pain intensity (Visual Analog Scale), upper-extremity disability (Disabilities of the Arm, Shoulder and Hand [DASH]), and thumb opposition (Kapandji score). Radiographic union, maintenance of reduction, length of hospital stay , time to return to work, and complications were evaluated. Results: Fifty-four patients were analyzed (CR-TSC, n = 31; PKW , n = 23). Early postoperative pain was significantly higher in the PKW group on postoperative day 1, while pain levels were comparable by week 4 and at final follow-up. Mid-term DASH scores did not differ between groups. Thumb opposition was significantly better, and return to work was earlier in the CR-TSC group. All fractures achieved union. Two transient superficial pin-tract infections occurred after PKW . Conclusion: When acceptable closed reduction is achievable, CR-TSC provides mid-term outcomes comparable to PKW while offering advantages in early pain, thumb opposition, and faster return to work, suggesting its role as an effective, patient-centered treatment option for Bennett fractures.
