Rolando fracture

Rolando fracture: Comminuted T- or Y-shaped intra-articular three-part fracture through the base of the first metacarpal (thumb) first described by Silvio Rolando (1873-1949) in 1910.

Commonly referred to as an ‘intra-articular thumb metacarpal base fracture with three or more segments’ or a comminuted Bennett fracture. This is an unstable injury that requires surgical reduction and fixation. Current treatment is an external fixator accompanied by the tension band wiring.

NOTE: Comminuted two-part base of first metacarpal fracture known eponymously as Bennett fracture, first described by Edward Hallaran Bennett in 1882

History of the Rolando fracture

1910 – Silvio Rolando publishes ‘Fracture de la base du premier metacarpien’.

I have found that there exists a type of fracture of the base of the first metacarpal that has not yet been described as far as I know. This fracture that I have noticed in 3 cases of 10 of base fractures follows an injury acting along the longitudinal axis of the metacarpal. It has a Y form and cannot be distinguished from a Bennett fracture without radiographic studies, and like the Bennett fracture, it has to have a special kind of treatment.

Rolando 1910; 33: 303–304

Associated Persons

• Silvio Rolando (1873-1949)
• Edward Hallaran Bennett (1837–1907)

Alternative names

• Rolando’s fracture
• Intra-articular thumb metacarpal base fracture with three or more segments

References

• Rolando S. Fracture de la base du premier metacarpien et principalement sur une variété non encore décrite. Presse Med 1910; 33: 303–304. [Translated Meals RA. Fracture of the base of the first metacarpal and a variation that has not yet been described. Clin Orthop Relat Res. 2006 Apr;445:15-8. PMID8641081]
• Proubasta IR. Rolando’s fracture of the first metacarpal. Treatment by external fixation. J Bone Joint Surg Br. 1992 May;74(3):416-7. [PMID 1587892]
• Howard FM. Fractures of the basal joint of the thumb. Clin Orthop Relat Res. 1987 Jul;(220):46-51. [PMID 3595009]
• Edmunds JO. Traumatic dislocations and instability of the trapeziometacarpal joint of the thumb. Hand Clin. 2006 Aug;22(3):365-92. [PMID 16843802]
• Sood A, Granick MS. Rolando Fracture. Eplasty. 2014; 14: ic16. [PMC4052793]