A Bennett’s fracture is a highly unstable, intra-articular fracture-dislocation uniquely occurring at the base of the first metacarpal. Which strong, intact anatomical structure firmly holds the small volar-ulnar avulsed fragment in its anatomic position while the main metacarpal shaft is pulled dorsally, radially, and proximally?

Explanation:
The correct option is d. The pathology of a Bennett's fracture relies entirely on opposing muscular and ligamentous forces. The strong anterior oblique ligament (also known as the volar beak ligament) anchors the small, medial triangular fracture fragment perfectly to the trapezium. Meanwhile, the abductor pollicis longus (APL) tendon, which inserts on the base of the first metacarpal, violently pulls the main shaft of the metacarpal proximally, dorsally, and radially. This massive deforming force makes closed reduction notoriously difficult to maintain, frequently necessitating percutaneous pinning or open reduction. Reference: Green's Operative Hand Surgery. Essential orthopaedic mcq.