Seventeen patients who had suffered a Bennett's fracture-dislocation have been reviewed with an average follow up of 26 years. All were treated conservatively. At review, only seven patients had symptoms, but all had a decreased range of movement and grip strength. Twelve had a characteristic deformity in the hand. Radiographs showed persistent subluxation of the first carpo-metacarpal joint and marked degenerative changes. We suggest that, in the light of the poor long-term outcome, this injury should not be managed conservatively but by some operative means.