Rolando Fracture

Rolando fracture

A Rolando fracture is a comminuted intra-articular fracture-dislocation of the base of thumb (proximal end of 1st metacarpal). Simply put, it is a comminuted Bennett’s 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. This is an unstable injury that requires surgical reduction and fixation.

References:
1. Manaster BJ et al. Musculoskeletal Imaging: The Requisites, 3rd edition. Mosby Elsevier 2007
2. Dahnert W. Radiology Review Manual, 5th edition. Lippincott, Williams and Wilkins 2003

Credit: Dr Donna D'Souza