It has also been described as a T or Y shaped fracture of the first metacarpal base.
Symptoms are similar to Bennett fracture.
Diagnosis is by x ray of the thumb.
Treatment of this fracture is difficult. As the joint surface is involved in the fracture hence restoration of accurate joint congruity is of utmost importance.
Methods of treatment include
traction (to align the fractured fragments) followed by plaster cast applicationexternal fixation (after traction a external frame is applied to hold the fragments)internal fixation with plate and screws (surgical incision is given and the fracture is reduced under direct vision)wilful neglect (plaster is applied till pain and swelling subside after which active use of the hand is encouraged)Internal fixation should only be undertaken by a experienced hand surgeon.
Wilful neglect should only be undertaken when there is no hope for adequate alignment of the fracture, (four to five bone fragments) even with internal fixation.
The fracture usually unites in three to four weeks after which active physiotherapy is started.
Will I regain adequate function of my thumb after this fracture?
Adequate function after the fracture depends upon number of fracture fragments (more the fragments poorer the function)adequate restoration of joint alignmentpresence of pre-existing osteoarthritis of the joint
The joint involved in this fracture is a common site of osteoarthritis and the presence of osteoarthritis, can result in poor functional out come.
I hope the information provided was helpful. If you have any query you can ask me at the contact me page.
This page was last updated on 6th February 2009.
Other causes of hand pain...Dupuytren Contracture
Compartment Syndrome
Hand Infection
Bennett Fracture
Hand Injury
Go back from Rolando Fracture to Hand Pain
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