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Epibasal thumb fracture

Case contributed by Andrew Dixon
Diagnosis certain

Presentation

Punched someone's face. Now sore thenar eminence.

Patient Data

Age: 17
Gender: Male
x-ray

Fracture base of the first metacarpal without intra-articular extension. Mild to moderate displacement. 

Case Discussion

Nice example of an epibasal fracture of the thumb (a.k.a. pseudo Bennett fracture). This two part fracture of the first metacarpal base does not extend to the articular surface allowing distinction from a true Bennett fracture.  A Rolando fracture is a comminuted intra-articular fracture of the first metacarpal base while skier's thumb occurs at the first metacarpophalangeal joint due to an avulsion injury of the ulnar collateral ligament. 

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