Bennett’s Fracture

• Definition: Bennett’s fracture is an intra-articular fracture of the base of the first metacarpal bone.
• Types:
  • Type I: Fracture of the base of the first metacarpal without dislocation of the carpometacarpal joint.
  • Type II: Fracture of the base of the first metacarpal with dislocation of the carpometacarpal joint.
  • Type III: Fracture of the neck of the first metacarpal.
• Causes: Fall onto the thumb, direct blow to the thumb.
• Clinical Features: Pain and swelling over the first metacarpal, difficulty in moving the thumb.
• Investigations: X-ray of the thumb to confirm the fracture.
• Complications: Malunion, nonunion, joint stiffness.
• Management: 1 → Reduction of the fracture → Immobilization in a thumb spica splint → Follow-up X-ray to confirm healing.

Rolando’s Fracture

• Definition: Rolando’s fracture is a comminuted fracture of the base of the first metacarpal bone.
• Types:
  • Type I: Comminuted fracture of the base of the first metacarpal.
  • Type II: Comminuted fracture of the neck and base of the first metacarpal.
• Causes: Fall onto the thumb, direct blow to the thumb.
• Clinical Features: Pain and swelling over the first metacarpal, difficulty in moving the thumb.
• Investigations: X-ray of the thumb to confirm the fracture.
• Complications: Malunion, nonunion, joint stiffness.
• Management: 1 → Reduction of the fracture → Internal fixation with a plate → Immobilization in a thumb spica splint → Follow-up X-ray to confirm healing.

Metacarpal Fractures

• Definition: Metacarpal fractures are fractures of the metacarpal bones.
• Types:
  • Extra-articular fractures: Fractures of the shaft of the metacarpal bones.
  • Intra-articular fractures: Fractures of the base of the metacarpal bones that involve the carpometacarpal joints.
• Causes: Fall onto the hand, direct blow to the hand.
• Clinical Features: Pain and swelling over the metacarpal bones, difficulty in moving the fingers.
• Investigations: X-ray of the hand to confirm the fracture.
• Complications: Malunion, nonunion, joint stiffness.
• Management: 1 → Reduction of the fracture → Immobilization in a hand splint → Follow-up X-ray to confirm healing.

Phalangeal Fractures

• Definition: Phalangeal fractures are fractures of the phalanges.
• Types:
  • Extra-articular fractures: Fractures of the shaft of the phalanges.
  • Intra-articular fractures: Fractures of the base of the phalanges that involve the interphalangeal joints.
• Causes: Fall onto the hand, direct blow to the hand.
• Clinical Features: Pain and swelling over the phalanges, difficulty in moving the fingers.
• Investigations: X-ray of the hand to confirm the fracture.
• Complications: Malunion, nonunion, joint stiffness.
• Management: 1 → Reduction of the fracture → Immobilization in a finger splint → Follow-up X-ray to confirm healing.

Imaging

• X-ray: X-ray of the hand is the primary imaging modality for diagnosing metacarpal and phalangeal fractures.
• CT scan: CT scan may be used to evaluate the extent of the fracture and to plan surgical treatment.
• MRI: MRI may be used to evaluate the soft tissue injuries associated with the fracture.

Management

• Reduction: Reduction of the fracture is the primary goal of treatment.
• Immobilization: Immobilization of the hand in a splint or cast is used to hold the fracture in place.
• Follow-up: Follow-up X-ray is used to confirm healing of the fracture.

Homoeopathic Therapeutic Approach

• Arnica montana: Used to treat pain and swelling associated with fractures.
• Hypericum perforatum: Used to treat nerve pain associated with fractures.
• Symphytum officinale: Used to promote healing of fractures.
• Rhus toxicodendron: Used to treat pain and stiffness associated with fractures.