Rolando fracture
Encyclopedia
The Rolando fracture is a comminuted
intra-articular fracture
through the base of the first metacarpal bone (the bone located just proximal to the thumb
). It was first described in 1910 by Silvio Rolando. This is a fracture consisting of 3 distinct fragments; it is typically T- or Y-shaped.
Some advocate fixation with Kirschner wires, or plate and screw constructions.
Another accepted treatment is an external fixator accompanied by the tension band wiring technique.
Tension band wiring is a technique in which the bone fragments are transfixed by Kirschner wire
s, which are then also used as an anchor for a loop of flexible wire. As the loop is tightened the bone fragments are compressed together.
, and is associated with a worse prognosis.
Comminuted
Comminuted may refer to:*comminuted bone, as in a crushed or splintered bone*comminuted material, which has been pulverised or titurated, such as Pulverised fuel ash in coal burning...
intra-articular fracture
Fracture
A fracture is the separation of an object or material into two, or more, pieces under the action of stress.The word fracture is often applied to bones of living creatures , or to crystals or crystalline materials, such as gemstones or metal...
through the base of the first metacarpal bone (the bone located just proximal to the thumb
Thumb
The thumb is the first digit of the hand. When a person is standing in the medical anatomical position , the thumb is the lateral-most digit...
). It was first described in 1910 by Silvio Rolando. This is a fracture consisting of 3 distinct fragments; it is typically T- or Y-shaped.
Treatment
There are several proposed methods of treatment. Interestingly the quality of reduction does not correlate with late symptoms and osteoarthritic changes. Despite this fact, the joint surface should be restored as close to it anatomical position as possible.Some advocate fixation with Kirschner wires, or plate and screw constructions.
Another accepted treatment is an external fixator accompanied by the tension band wiring technique.
Tension band wiring is a technique in which the bone fragments are transfixed by Kirschner wire
Kirschner wire
Kirschner wires or K-wires or pins are sterilized, sharpened, smooth stainless steel pins. Introduced in 1909 by Martin Kirschner, the wires are now widely used in orthopaedics and other types of medical and veterinary surgery. They come in different sizes and are used to hold bone fragments...
s, which are then also used as an anchor for a loop of flexible wire. As the loop is tightened the bone fragments are compressed together.
Prognosis
The Rolando fracture is less common than the Bennett's fractureBennett's fracture
Bennett's fracture is a fracture of the base of the first metacarpal bone which extends into the carpometacarpal joint. This intra-articular fracture is the most common type of fracture of the thumb, and is nearly always accompanied by some degree of subluxation or frank dislocation of the...
, and is associated with a worse prognosis.
External links
- Wheeless: Rolando's fracture
- Traumatic Dislocations and Instability of the Trapeziometacarpal Joint of the Thumb Edmunds JO. Hand Clin Volume 22, pp. 365–392, 2006.