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Rolando fracture
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Rolando fracture

Contributors: Derek T. Schloemann MD, MPHS, Danielle Wilbur MD
Other Resources UpToDate PubMed

Synopsis

Causes / typical injury mechanism: The Rolando fracture classically represents a Y-shaped intra-articular fracture of the first (thumb) metacarpal base. It arises as a result of an axial load (eg, a fall or a punch) on a flexed first metacarpal.

Classic history and presentation: The patient will typically present with pain at the first metacarpal base with or without associated swelling. The anterior oblique ligament anchors the volar fragment of the first metacarpal base while the first metacarpal shaft undergoes proximal displacement.

Prevalence: As many as 1.4% of all fractures and 21% of metacarpal fractures are Rolando fractures.
  • Age – The injury usually occurs between the ages of 20 and 40 years.
  • Sex / gender – It is more common in males.

Codes

ICD10CM:
S62.226A – Nondisplaced Rolando's fracture, unspecified hand, initial encounter for closed fracture
S62.226B – Nondisplaced Rolando's fracture, unspecified hand, initial encounter for open fracture

SNOMEDCT:
208404004 – Closed fracture thumb metacarpal base, intra-articular, Rolando
208421008 – Open fracture thumb metacarpal base, intra-articular, Rolando

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Bennett fracture
  • First metacarpal shaft fracture
  • Thumb proximal phalanx fracture
  • Scaphoid fracture
  • Perilunate dislocation (lunate dislocation)
  • Thumb collateral ligament injury
  • Thumb CMC joint dislocation
  • Thumb interphalangeal joint dislocation
  • Thumb flexor tendon rupture
  • Thumb extensor tendon rupture
  • Basilar thumb arthritis
  • Thumb interphalangeal joint arthritis
  • Scaphotrapeziotrapezoidal (STT) arthritis
  • Scaphoid nonunion advanced collapse (SNAC) of the wrist
  • Scapholunate advanced collapse (SLAC) of the wrist

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed:07/14/2020
Last Updated:03/26/2021
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Rolando fracture
Copyright © 2021 VisualDx®. All rights reserved.