Surgical versus non-operative treatment for Bennett’s fractures of the thumb. A matched patient cohort study Dataset

<b>Aims:</b><br>Bennett’s fractures can be managed operatively or nonoperatively, but there is uncertainty regarding the long-term outcomes and superiority of each approach. This study evaluates whether surgical treatment offers superior medium-term outcomes compared to nonoperative management.<b>Methods:</b><br>We retrospectively reviewed patients treated surgically for displaced Bennett’s fractures over a four-year period in our unit. Each surgical patient was matched with a nonoperatively managed control. At a minimum of five years post-injury, patients were assessed in clinic for grip and pinch strength, pain, satisfaction, and radiographic evidence of osteoarthritis. Functional outcomes were evaluated using the brief Michigan Hand Questionnaire (bMHQ) and the Disability of the Arm, Shoulder and Hand (DASH) questionnaire.<b>Results:</b><br>Thirty-three surgically treated patients were identified and matched with nonoperative counterparts. At follow-up, the surgical group demonstrated significantly better grip strength, lower DASH scores, greater first web space angles, and higher satisfaction scores compared to the nonoperative group.<b>Conclusions:</b><br>While both surgical and nonoperative approaches can yield excellent outcomes when fracture reduction is adequately achieved and maintained, surgical fixation was associated with improved grip strength, functional scores, and patient satisfaction at five-year follow-up. Closed reduction and percutaneous pinning remains a reliable option when satisfactory reduction cannot be achieved in a nonoperative setting.

**研究目的：** 贝内特骨折(Bennett's fracture)可采用手术或非手术方式治疗，但目前对于两种方案的长期预后及各自优劣仍存在争议。本研究旨在评估手术治疗相较非手术治疗，是否可获得更优的中期预后效果。
**研究方法：** 本研究回顾性分析了本科室四年内收治的移位型贝内特骨折手术治疗患者，为每例手术患者匹配1例接受非手术治疗的对照患者。在受伤至少五年后，对所有患者进行门诊随访评估，评估内容包括握力、捏力、疼痛程度、患者满意度以及影像学提示的骨关节炎征象。功能预后采用简明密歇根手功能问卷（brief Michigan Hand Questionnaire, bMHQ）与上肢、肩与手功能障碍问卷（Disability of the Arm, Shoulder and Hand, DASH）进行评价。
**研究结果：** 本研究共纳入33例手术治疗患者，并匹配得到相应的非手术治疗对照队列。随访结果显示，相较于非手术治疗组，手术治疗组患者的握力显著更优，DASH评分更低，第一指蹼间隙角度更大，且患者满意度评分更高。
**研究结论：** 尽管当骨折复位充分且维持良好时，手术与非手术治疗均可获得优异的预后效果，但在五年随访期内，手术固定与更佳的握力、功能评分及患者满意度密切相关。当非手术治疗无法获得满意复位时，闭合复位经皮穿针固定仍是可靠的治疗选择。