We need you! See something you could improve? Make an edit and help improve WikSM for everyone.

Rolando Fracture

From WikiSM
Jump to: navigation, search

Other Names

  • 1st metacarpal fracture
  • Comminuted intra-articular fracture-dislocation of the base of the proximal first metacarpal
  • Rolando fracture

Background

  • This pager refers to comminuted intra-articular fracture-dislocation of the base of the proximal first metacarpal
    • Eponymously named 'Rolando' fracture

History

  • Named after Italian surgeon Sylvio Rolando (need citation)

Epidemiology


Pathophysiology

Illustration of Rolando fracture[1]
Intra-articular fracture/dislocation of the first metacarpal (aka Rolando fracture).[2]

Risk Factors

  • unknown

Differential Diagnosis


Clinical Features

  • History
    • Patients report pain, swelling at the base of the thumb
    • Worse with use of thumb or hand
  • Physical: Physical Examination Hand
    • Inspection: Swelling, bruising
    • Palpation: Tenderness at base of thumb

Evaluation

Comminuted intra-articular fracture-dislocation of the base of the thumb (proximal first metacarpal).[3]

Radiographs

Ultrasound

  • Role in Rolando fracture is unclear
    • 5% sensitivity and 98.3% specificity for hand fractures[4]
    • Water bath technique can help

CT

  • Useful to clarify complex fracture patterns

Classification

  • N/A

Management

Nonoperative

Operative

  • Indications
    • All
  • Technique
    • ORIF

Rehab and Return to Play

Rehabilitation

  • Needs to be updated

Return to Play/ Work

  • Needs to be updated

Complications and Prognosis

Prognosis

  • Needs to be updated

Complications


See Also


References


  1. Image courtesy of https://surgeryreference.aofoundation.org/, "Metacarpal, Rolando fracture"
  2. Case courtesy of Assoc Prof Frank Gaillard, Radiopaedia.org, rID: 35855
  3. Case courtesy of Dr MT Niknejad, Radiopaedia.org, rID: 61566
  4. Blaivas, Michael, et al. “Water bath evaluation technique for emergency ultrasound of painful superficial structures.” The American journal of emergency medicine 22.7 (2004): 589-593.
Created by:
John Kiel on 15 August 2019 21:20:45
Authors:
Last edited:
15 May 2022 01:35:37
Categories:
Trauma | Finger | Hand | Wrist | Fractures