Postoperative Rehabilitation and Functional Outcomes in Reverse Bennett Fracture: A Case Report

Background: One of the commonest fractures involving the upper limb is metacarpal fractures; these frequently involve the fifth metacarpal bone. Intra-articular fractures and dislocation involving the base of the fifth metacarpal are often termed reverse or "baby" Bennett's fractures and are considered unstable due to muscle traction and the mobility of the carpometacarpal joint. Though implant fixation helps stabilize the fracture, rehabilitation is important post-operatively for functional improvement. Case Presentation: An 18-year-old right-hand-dominate patient suffered a reverse Bennett fracture of the right fifth metacarpal due to a fall onto an outstretched hand. The patient received open reduction and internal fixation with a plate-screw fixator. Four weeks later, he returned to the out-patient department with pain, stiffness, muscle wasting, and marked disability of the wrist and hand. Clinical assessment revealed severe restriction of joint motion of the fifth metacarpophalangeal joint, restricted motion of the wrist and forearm, along with a DASH score of 48.3, representing moderate disability. Intervention: A physiotherapy program was started, including early mobilization, Maitland joint mobilization methods, and progressive tendon gliding exercises. Initially, the treatment plan concentrated on pain control and joint mobilization techniques, progressing through advanced mobilization, flexor tendon gliding, and strengthening exercises. Outcomes: After completing 20 days of supervised physiotherapy, the patient gained complete pain-free range of motion in the wrist and fingers, along with complete recovery in the motion of the little finger. Functional assessment revealed a marked improvement in the DASH score, which reduced to 6.7, indicating minimal disability. The patient was very satisfied with the results and was able to use his hands functionally. Conclusion: The important role of early structured physiotherapy in managing reverse Bennett fractures that are surgically fixed is made evident in this case. Fixation that enables early mobilization of the hand will contribute significantly to functional restoration while preventing postoperative complications such as stiffness. Further studies must be conducted to provide structured evidence-based management for such a complex condition.