A Rolando fracture is a complex intra-articular fracture of the base of the first metacarpal bone, characterized by a Y- or T-shaped fracture pattern, which typically involves the thumb. This type of fracture often occurs due to a high-energy trauma, such as a fall on an outstretched hand or a direct blow, and it is more prevalent in individuals who engage in physically demanding sports or activities. The fracture is named after the Italian surgeon Giovanni Rolando, who first described it in the 19th century. Patients commonly present with swelling, tenderness, and deformity at the base of the thumb, along with difficulty in moving the thumb. Diagnosis is primarily made through radiographic imaging, where X-rays reveal the distinct fracture pattern, often accompanied by articular involvement, which can lead to arthritis if not properly treated. Treatment options for Rolando fractures depend on the degree of displacement and the patient's functional needs. In many cases, a closed reduction may achieve satisfactory alignment, after which a casts or splints is applied to stabilize the joint. However, if the fracture is significantly displaced or irreducible, surgical intervention may be required. This can involve internal fixation techniques, such as the use of plates, screws, or pins, aiming to restore normal anatomy and function to the joint. Post-operative care typically includes rehabilitation focused on restoring range of motion and strength. Complications associated with Rolando fractures can include non-union, malunion, and osteoarthritis, underscoring the importance of early, effective management. In summary, a Rolando fracture is a significant injury that can impact the thumb's function, requiring careful assessment and individualized treatment to ensure optimal recovery and return to daily activities.
