ROLANDO FRACTURE 

Rolando fracture is an intraarticular three-part fracture of the base of the first metacarpal that has a poorer prognosis than a Bennett fracture. Here's a quick summary.

• Intraarticular three-part or comminuted fracture of the base of the first metacarpal 

• 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 pull of the abductor pollicis longus muscle 

• Poorer prognosis than Bennett fracture 

• Mechanism: Axial force applied to the thumb in flexion (blow with the fist) 

• Exam: Swelling and tenderness at the base of the thumb with limited range of motion 

• ED Management: Pain control, immobilize 

• Splint: Thumb spica 

• Ortho consult: Yes 

• Disposition: Pending orthopedic recommendations, majority require operative management 



MH/CCF/CWRU EM Res @MetroHealth_EM



#Rolando #Fracture #Thumb #Metacarpal #Radiology #XRay #Diagnosis #Management #Hand #Orthopedics #MSK