A Rolando Fracture is a fracture to the base of the thumb, similar to a Bennett fracture, although more complex to treat. It is usually 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.
- Severe pain when trying to move the thumb.
What is a Rolando fracture?
A Rolando fracture is a break to the bones at the base of the thumb joint. This is called the carpometacarpal joint because it is where the carpal bone in the wrist joins the metacarpal bone.
The difference between a Rolando fracture and a Bennett fracture is that with a Rolando fracture, the base of the metacarpal is fractured into 2 or 3 fragments. This is known as a T or Y shaped fracture because of its appearance.
Treatment for 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.
- The procedure involves realigning the bone fragments and then fixing them with internal wires or pins.
- In some cases, an external frame with pins is used.
- The joint is then immobilized for 4 to 6 weeks in a thumb spica cast, where the thumb is kept separate from the hand.
- When the cast is removed, the patient is referred to a physiotherapist or physical therapist or similar who will help mobilize the joint.
Mobility and hand strengthening exercises should be done as part of a full rehabilitation program. When getting back into sport, the use of a protective thumb splint or support is recommended.