Rolando fracture is a three part or comminuted intra-articular fracture-dislocation of the base of thumb (proximal first metacarpal). It can be thought of as a comminuted Bennett fracture.
The mechanism is usually an axial blow to a partially flexed metacarpal, such as a fistfight. The fracture line is typically T or Y-shaped. The volar fragment remains attached to the carpometacarpal joint, while the main dorsal fragment subluxes or dislocates dorsally and radially due to the unopposed pull of abductor pollicis longus.
Treatment and prognosis
This is an unstable injury that requires surgical reduction and fixation.
Histology and etymology
It is named after Silvio Rolando (Italian surgeon).
epibasal (pseudo Bennett) fracture
- extra-articular fractures through the first metacarpal base
- two-part intra-articular fracture through the first metacarpal base
Wrist and hand fractures
- wrist and hand fractures (Amsterdam wrist rules)
- distal radial fracture (Frykman classification)
- distal ulna fractures
- fracture dislocations of the radius and ulna
- carpal fractures
- metacarpal fractures
- phalanx fractures
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- 2. Dähnert W. Radiology Review Manual. Philadelphia : Lippincott Williams & Wilkins, c2003. (2003) ISBN:0781738954. Read it at Google Books - Find it at Amazon