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
