β£What are the eponyms?Bennett = partial articularRolando = complete articularβ£What are the deforming forces in base of thumb fractures?3 main tendons and 1 ligament deforming the fractureDistal fragment is Displaced PROXIMALLY (APL), DORSALLY (EPL) and ULNARLY (Adductor PB)Abductor Pollicis Longus β Base of MC1 β pulls distal fragment proximally and dorsallyAdductor Pollicis Brevis β Base of P1 β pulls distal fragment ulnarlyEPL β Base on P2 β Pulls distal fragment dorsallyBeak's ligament (Anterior Oblique Ligament) holds on to the proximal fragmentβ£What is the reduction maneuver for Bennett's Fracture?Longitudinal traction, pronation and pressure at 1st MC baseβ£Suitablity for non operative treatment?<2mm step, < 25% articular surface β Thumb Spica Castβ£Surgical management?CRPP if closed reduction possibleIf not, ORIFβ£What is the approach to the base of thumb?β£1. Wagner Radiopalmar approachPlane = thenar muscles// APL (first extensor compartment)Danger - SRN dorsal sensory nerveI = between glaborous and hairy skin following the thenar eminence in a gentle curveS = Find APL tendon and nerves, detach thenar musclesDeep = Perform longitudinal capsulotomyβ£2. Dorsoradial approach - 1EC // 3ECPlane = Between first and third extensor compartmentsI = straight incision between EPL and EPBS = Incise fascia between the 2 tendonsD = longitudinal capsulotomy