Specialty Hand surgery eMedicine orthoped/288 | ICD-10 S62.2 | |
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The Rolando fracture is a comminuted intra-articular fracture through the base of the first metacarpal bone (the first bone forming the thumb). It was first described in 1910 by Silvio Rolando. This is a fracture consisting of 3 distinct fragments; it is typically T- or Y-shaped.
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Treatment
There are several proposed methods of treatment. Interestingly the quality of reduction does not correlate with late symptoms and osteoarthritic changes. Despite this fact, the joint surface should be restored as close to its anatomical position as possible. Some advocate fixation with Kirschner wires, or plate and screw constructions. Another accepted treatment is an external fixator accompanied by the tension band wiring technique.
Tension band wiring is a technique in which the bone fragments are transfixed by Kirschner wires, which are then also used as an anchor for a loop of flexible wire. As the loop is tightened the bone fragments are compressed together.
Prognosis
The Rolando fracture is less common than the Bennett's fracture, and is associated with a worse prognosis.