Rolando fractures

Fractures of the base of the thumb metacarpal can be divided into extra-articular and intra-articular fractures. Intra-articular fractures are subdivided into Bennett and Rolando fractures. In 1882, Edward Hallaran Bennett, described a fracture at the base of the first metacarpal that bears his name. This fracture is an avulsion of the main substance of the thumb metacarpal from the volar-ulnar aspect of the metacarpal base. The remaining metacarpal base subluxates radially, proximally, and dorsally. One hundred years ago, Silvio Rolando described a specific tripartite fracture of the base of the thumb metacarpal with Y-shaped intra-articular into trapeziometacarpal (TMC) joint. The eponym "Rolando fracture," is broadly used to describe any comminuted intra-articular fracture at the base of the first metacarpal. The optimal treatment method for a Rolando fracture has not been established. The purpose of this article is to provide a comprehensive review of this fracture, including the anatomy and biomechanics, incidence, etiology, pathophysiology and diagnosis, with special emphasis on treatment. © 2010 Wolters Kluwer Health | Lippincott Williams and Wilkins.