You are here

Rolando Fracture S62.22 815.01

synonyms:Rolando fracture, thumb metacarpal base fracture

Rolando Fracture ICD-10

Rolando Fracture ICD-9

  • 815.01(closed fracture base of thumb metacarpal)
  • 815.11(open fracture base of thumb metacarpal)
  • 815.00 (closed metacarpal fracture; unspecified)

Rolando Fracture Etiology / Epidemiology / Natural History

  • Pilon type fracture of the thumb metacarpal base usually into T or Y configurations.
  • Generally results from axial loads.

Rolando Fracture Anatomy

  • Abductor pollicis longus and adductor pollicis displace the metacarpal radially and proximally.
  • Anterior oblique ligament remains attached to fracture fragment.

Rolando Fracture Clinical Evaluation

  • Pain, swelling, ecchymosis at the thumb MC base.
  • Document neurovascular exam.

Rolando Fracture Xray / Diagnositc Tests

  • P/A, lateral and oblique views of the thumb.
  • True lateral view: palmar surface of the hand is placed flat on cassette; hand and wrist are pronated 15°-35° . Tube directed obliquely 15°distal-to-proximal, centered over the trapeziometacarpal joint (Billing L, Acta Radiol1952; 38:471).
  • CT: consider for pre-operative eval of comminution.

Rolando Fracture Classification / Treatment

  • 3-part Rolando fracture: ORIF with multiple Kirschner pins or plate +/-bone graft.
  • Severe comminution: External fixation with ligamentotaxis reduction of displaced fragments +/- articular reduction with Kirschner pins

Rolando Fracture Associated Injuries / Differential Diagnosis

Rolando Fracture Complications

  • Infection
  • Malunion
  • Arthritis
  • Stiffness / Contracture
  • Nonunion
  • Pain
  • Painful hardware

Rolando Fracture Follow-up Care

  • Post-op: Thumb spica splint, elevation, NWB
  • 7-10 Days: Wound check, Thumb spica cast
  • 6 Weeks: K-wire removal, begin ROM exercises provided union is evident on xray.
  • 3 Months: Evaluated ROM. Sport specific rehab.
  • 6 Months:
  • 1Yr: f/u xrays, Assess outcome. Consider trapeziometacarpal arthrodesis for persistant pain with radiographic evidence of articular incongruity.

Rolando Fracture Review References

Disclaimer

The information on this website is intended for orthopaedic surgeons.  It is not intended for the general public. The information on this website may not be complete or accurate.  The eORIF website is not an authoritative reference for orthopaedic surgery or medicine and does not represent the "standard of care".  While the information on this site is about health care issues and sports medicine, it is not medical advice. People seeking specific medical advice or assistance should contact a board certified physician.  See Site Terms / Full Disclaimer