Rolando fracture
Citation, DOI, disclosures and article data
Citation:
Gaillard F, Lustosa L, Bickle I, et al. Rolando fracture. Reference article, Radiopaedia.org (Accessed on 23 Mar 2025) https://doi.org/10.53347/rID-1991
rID:
1991
Article created:
Disclosures:
At the time the article was created Frank Gaillard had no recorded disclosures.
View Frank Gaillard's current disclosures
Last revised:
Disclosures:
At the time the article was last revised Leonardo Lustosa had no financial relationships to ineligible companies to disclose.
View Leonardo Lustosa's current disclosures
Revisions:
18 times, by
13 contributors -
see full revision history and disclosures
Systems:
Synonyms:
- Rolando's fracture
- Rolando fractures
Rolando fracture is a three-part or comminuted intra-articular fracture-dislocation of the base of the thumb (proximal first metacarpal). It can be thought of as a comminuted Bennett fracture.
On this page:
Epidemiology
The vast majority of cases occur in men, with a male to female predominance of 10:1. It is most common in the 20 to 40 years age range 3.
Pathology
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/dislocates dorsally and radially due to the unopposed pull of the abductor pollicis longus muscle.
Treatment and prognosis
This is an unstable injury that requires surgical reduction and fixation.
History and etymology
It is named after Silvio Rolando (Italian surgeon) who first described the fracture in a small case series of thumb metacarpal fractures in 1910. In his article, three of the twelve patients had a Rolando fracture 3.
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Differential diagnosis
-
epibasal (pseudo-Bennett) fracture
- extra-articular fractures through the first metacarpal base
-
Bennett fracture
- two-part intra-articular fracture through the first metacarpal base
Quiz questions
References
- 1. Manaster BJ, Disler DG, May DA et-al. Musculoskeletal imaging, the requisites. Mosby Inc. (2002) ISBN:0323011896. Read it at Google Books - Find it at Amazon
- 2. Dähnert W. Radiology Review Manual. Philadelphia : Lippincott Williams & Wilkins, c2003. (2003) ISBN:0781738954. Read it at Google Books - Find it at Amazon
- 3. M Mahoney, D Marsland, L Garagnani, P Sauvé. Rolando and his fracture:. (2014) Trauma. doi:10.1177/1460408614532046
Incoming Links
Articles:
- Bennett fracture
- Wrist radiograph (checklist)
- Fractures of the thumb
- Green and O'Brien classification of thumb metacarpal fractures
- Eponymous fractures
- Thumb pathology
- Epibasal fracture of the thumb
- Gamekeeper's thumb
- Metacarpal fracture
- Hand radiograph (checklist)
- Dorsal deltoid ligament complex of the thumb
- Hand radiograph (an approach)
- Upper extremity fractures
Cases:
- Base of first metacarpal fracture and hand cuffs
- Rolando fracture
- Unstable Bennett fracture
- Radial collateral ligament avulsion injury- thumb
- Rolando fracture
- Green and O'Brien classification of thumb metacarpal fractures
- Thumb metacarpal fractures (illustration)
- Bennet fracture
- Bennet fracture
- Bennett fracture
- Epibasal thumb fracture
- Bennett fracture
- Rolando fracture
- Bennett fracture
- Rolando fracture
Multiple choice questions:
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