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A Rolando Fracture is a fracture to the base of the 1st metacarpal where it joins the carpal bones between the thumb and the wrist. This is similar to the Bennett fracture, although a little more complex to treat.
A Rolando fracture will most likely be caused by a sudden impact or trauma such as punching something hard. The patient will feel immediate severe pain on the thumb side of the wrist. There will be rapid swelling and bruising may appear. The thumb may appear deformed depending on the level of bone displacement and the patient will experience great difficulty and a high level of pain when trying to move the thumb.
The difference between a Rolando fracture and a Bennett fracture is that with a Rolando fracture the base of the metatarsal is fractured into 2 or 3 fragments (occasionally more). This is known as a T or Y shaped fracture due to its appearance.
Treatment of a Rolando fracture
Surgery is almost always required. It is essential the all the bone fragments are put back in place and pinned or screwed if needed. See Rolando fracture surgery for more information and an interview with specialist wrist and hand surgeon Elliot Sorene.
The procedure involves realigning the bone fragments and then fixing them with either internal wires or pins, or an external frame and pins. The joint is then immobilized in a thumb spica cast (where the thumb is kept separate from the hand) for 4 to 6 weeks.
When the cast is removed, the patient is referred to a physiotherapist, physical therapist or similar who will help mobilize the joint as well as giving some home exercises for strength and mobility. When getting back to sport, the use of a protective thumb splint or support is recommended.
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