A Bennett’s fracture refers to a fracture of the base of the 1st metacarpal, the long bone that articulates with the thumb. As this is an intra-articular (occurring within the joint capsule), the injury often involves damage to the structures around the adjacent joint and the adjacent bone (the trapezium) (1). This injury typically occurs with excessive axial compression (compression down the line of the bone), causing the 1st metacarpal to be driven down into the hand, or by direct impact to the bone. 

Most athletes will report localised pain around the area, often accompanied by swelling and malalignment, as well as severe thumb weakness. 

Due to the muscular forces that act on the metacarpal, this fracture results in a high degree of instability, and as such has poor outcomes with conservative management. For recreational athletes, this injury is usually managed with wire fixation and a cast for 4 to 6 weeks. For professional athletes, the trend is to utilise plate fixation to allow for early movement (2)

  1. Ellis H. Edward Hallarran Bennett: Bennett’s fracture of the base of the thumb. J Perioper Pract. 2013;23(3):59–60.
  2. Fufa DT, Goldfarb CA. Fractures of the thumb and finger metacarpals in athletes. Hand Clin. 2012;28(3):379–388.

About the author

Sam Gilbert

Sam Gilbert is a registered physiotherapist with the Australian Physiotherapy Association (APA) and certified strength and conditioning specialist (CSCS) with the National Strength and Conditioning Association (NSCA). He holds a bachelor’s degree in Physiotherapy from Latrobe university (Melbourne, Australia) and a master’s degree in Exercise Science (Strength and Conditioning) from Edith Cowan University (Perth, Australia).

A 3rd Dan black belt in Shinkyokushinkai Karate under the World Karate Organisation (WKO), Sam participated for over 20 years in full contact competition, winning multiple state and national titles, and culminating in a 4th place in the heavyweight division of the Shinkyokushinkai World Cup in 2009.

As the co-founder and clinical director of Club 360, the premier multi-disciplinary health and fitness center in Tokyo, Japan, Sam has combined his practical experience with an in-depth study of sports performance in relation to combat sports, and strives to help other combat athletes reach their full competitive potential, whilst at the same time decreasing injury risk and increasing competition and training potential.

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By Sam Gilbert