Rolando fracture

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Rolando fracture
X-ray of a Rolando fracture
Synonyms	Comminuted intra-articular fracture of the base of the first metacarpal
Pronounce	N/A
Specialty	N/A
Symptoms	Pain, swelling, deformity at the base of the thumb
Complications	Osteoarthritis, malunion, stiffness
Onset	Acute, following trauma
Duration	Varies, depending on treatment
Types	N/A
Causes	Trauma to the thumb, often from a fall or direct impact
Risks	Contact sports, falls, accidents
Diagnosis	X-ray, CT scan
Differential diagnosis	Bennett fracture, other thumb fractures
Prevention	N/A
Treatment	Surgery, immobilization
Medication	Pain management, NSAIDs
Prognosis	Generally good with proper treatment, but may lead to arthritis
Frequency	Rare compared to other thumb fractures
Deaths	N/A

A Rolando fracture, also known as a comminuted intra-articular fracture of the base of the first metacarpal bone, is a specific type of hand fracture that involves the thumb. It is named after Silvio Rolando, an Italian surgeon who first described this fracture pattern in 1910.

Causes

The most common cause of a Rolando fracture is a direct impact or forceful trauma to the thumb. This can occur during sports activities, such as skiing or football, or due to accidents like falls or car collisions. The fracture typically occurs when the thumb is forced backward or jammed, causing the base of the first metacarpal bone to break into multiple fragments.

Symptoms

Symptoms of a Rolando fracture may include severe pain, swelling, bruising, and deformity at the base of the thumb. The thumb may also be difficult to move or use, and there may be a noticeable loss of strength or grip. In some cases, the fracture fragments may be visible through the skin, indicating an open fracture.

Diagnosis

To diagnose a Rolando fracture, a healthcare professional will perform a thorough physical examination of the hand and thumb. They may also order imaging tests, such as X-rays or CT scans, to assess the extent and location of the fracture. These tests help determine the severity of the fracture and guide the appropriate treatment plan.

Treatment

The treatment of a Rolando fracture depends on various factors, including the severity of the fracture, the patient's age, and their overall health. In some cases, non-surgical treatment options may be sufficient, such as immobilization with a cast or splint to allow the fracture to heal. However, for more complex fractures or cases with significant displacement, surgical intervention may be necessary. Surgical treatment typically involves realigning the fractured bone fragments and stabilizing them with screws, plates, or wires. This helps promote proper healing and restores the thumb's function and strength. After surgery, a period of immobilization and rehabilitation is usually required to aid in the recovery process.

Complications

Complications associated with a Rolando fracture can include infection, delayed or non-union (failure of the bone to heal), malunion (improper alignment of the bone fragments), stiffness, and loss of range of motion. These complications can impact the overall outcome and functionality of the thumb, highlighting the importance of proper diagnosis and treatment.

Prevention

While it may not be possible to prevent all Rolando fractures, certain precautions can help reduce the risk. These include wearing appropriate protective gear during sports activities, practicing proper hand safety techniques, and avoiding situations that may lead to traumatic injuries.

See Also

• Hand Fractures
• Metacarpal Fractures

References

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