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The Journal of Bone and Joint Surgery 81:893 (1999)
© 1999 The Journal of Bone and Joint Surgery, Inc.

Correspondence

Correspondence

Julian Chell, F.R.C.S, S. Surendran, F.R.C.S., Peter J. Livesley, F.R.C.S. (Orth), Joseph P. Cullen, M.D., Michael A. Parentis, M.D., Vernon M. Chinchilli, Ph.D and Vincent D. Pellegrini, Jr., M.D.

TO THE EDITOR:

We read with interest "Simulated Bennett Fracture Treated with Closed Reduction and Percutaneous Pinning. A Biomechanical Analysis of Residual Incongruity of the Joint" (79-A: 413–420, March 1997), by Cullen et al., which showed the unloading effect of articular incongruity after imperfect reduction of the palmar beak fragment. However, because the authors referred only to medium-term studies regarding outcome even though the results of a long-term study (average duration of follow-up, 26.4 years) has been published4, their conclusions are flawed.

Cullen et al. chose to study the biomechanics of the joint with use of lateral pinch-testing; however, this function was found to be only slightly impaired after a Bennett fracture. In the long-term study by one of us (P. J. L.), more severe impairment was noted in pinch grip strength4. This activity may place a greater load across the area of incongruity and thereby lead to . . . [Full Text of this Article]


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