Comminuted intra-articular fracture-dislocation of the base of the thumb (proximal first metacarpal)
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.
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 .
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.
This is an unstable injury that requires surgical reduction and fixation.
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M Mahoney, D Marsland, L Garagnani, P Sauvé. Rolando and his fracture:. (2014) Trauma. doi:10.1177/1460408614532046
