Objective: The thumb is very exposed to trauma due to its position and function. Fractures of the base of the first metacarpal bone are very frequent in hand traumatology. Most Bennett’s fractures are treated surgically. However, the optimal surgical approach is controversial. The aim of this study is to compare the results of closed reduction and percutaneous pinning in the treatment of Bennett’s fracture of the base of firsthand metacarpal in fractures with both small and large fragments. Methods: We studied retrospectively the data of 40 patients treated for a Bennett’s fracture in the department of orthopaedic and traumatologic surgery between January 2016 and December 2018. The purpose of this study was to compare the functional (pain, grip strength, first web space opening and thumb opposition) and radiological (quality of reduction and arthritic changes) results of the Iselin’s technique for the treatment of Bennett’s fractures in two groups of patients with large and small bone fragments according to the size of articular surface detached with the antero-medial fragment (superior or inferior to 25%). Results: The average age of the patients was 34 (range = 19–66) years. Males were by far the most affected (90%). We noted 24 cases of large fragment fractures (60%) and 16 cases of small fragment fracture (40%). An excellent overall functional result was found in 68.8% of cases of small fragment fractures versus 50% of cases of large fragment fractures. Radiological results were roughly similar. Conclusion: All surgical techniques aim to restore the articular congruence to the best, maintain the opening of the first web space and obtain a stable and painless trapezo-metacarpal joint. The Iselin’s technique is simple, inexpensive and easy to perform even by inexperienced surgeons. It yields satisfactory results in most cases of Bennett’s fracture regardless of the size of the fragment.

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Objective: Fractures of the proximal humerus are common injuries. Treatment options vary according to fracture patterns, surgeon preferences and implant availability. Increasing interest is being given to minimally invasive surgical procedures. In this article an original surgical procedure is described combining percutaneous retrograde intramedullary pinning (PRIP) and open reduction with lag screw fixation in the treatment of displaced Neer three-part fractures of the proximal humerus. Methods: We report on the preliminary results of a retrospective series of six patients treated with PRIP and open lag screw fixation reviewed with a mean follow-up of 25 months. Radiologic assessment was made on plain x-rays. Functional results were assessed according to the Constant and Murely score, the disabilities of the arm, shoulder and hand (DASH) score, and the analogue visual score (AVS). Results: Radiologic reduction was “anatomical” in all the patients. The average Absolute Constant Score (ACS) was 55.16 (range from 30 to 80). The average DASH score was 27.3 (range from 19 to 36). Only one case of proximal pin migration was reported. Conclusion: The association of PRIP with open reduction and lag screw fixation can be an interesting alternative yielding good results in our developing countries where more advanced fixation devices are not readily available.