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Rolando Fracture Workup

  • Author: John J Walsh, IV, MD; Chief Editor: Harris Gellman, MD  more...
 
Updated: Jan 15, 2014
 

Imaging Studies

Anteroposterior (AP) and lateral radiographs of the thumb often do not reveal the full extent of articular comminution (see image below)

Lateral radiograph of a Rolando fracture. Note howLateral radiograph of a Rolando fracture. Note how the comminution is not easily viewed on this film.

Additional radiographic views include a Robert radiograph (a hyperpronated view of the thumb base), tomography, as seen in the images below, and computed tomography (CT) scanning (see images below).

Lateral tomograph of a Rolando fracture clearly shLateral tomograph of a Rolando fracture clearly shows the varus angulation at the fracture, as well as the multiple fragments of the articular surface.
Anteroposterior tomograph of a Rolando fracture fuAnteroposterior tomograph of a Rolando fracture further emphasizes the extent of comminution of the articular surface (same patient as in Image above).

Improved assessment of the number of fragments and metaphyseal impaction can aid in decision making for open reduction versus external fixation.

 
 
Contributor Information and Disclosures
Author

John J Walsh, IV, MD Professor and Chairman, Department of Orthopedic Surgery, University of South Carolina School of Medicine

John J Walsh, IV, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, Christian Medical and Dental Associations, American Society for Surgery of the Hand

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Michael Yaszemski, MD, PhD Associate Professor, Departments of Orthopedic Surgery and Bioengineering, Mayo Foundation, Mayo Medical School

Disclosure: Nothing to disclose.

Chief Editor

Harris Gellman, MD Consulting Surgeon, Broward Hand Center; Voluntary Clinical Professor of Orthopedic Surgery and Plastic Surgery, Departments of Orthopedic Surgery and Surgery, University of Miami, Leonard M Miller School of Medicine, Clinical Professor, Surgery, Nova Southeastern School of Medicine

Harris Gellman, MD is a member of the following medical societies: American Academy of Medical Acupuncture, American Academy of Orthopaedic Surgeons, American Orthopaedic Association, American Society for Surgery of the Hand, Arkansas Medical Society

Disclosure: Nothing to disclose.

Additional Contributors

A Lee Osterman, MD Director of Hand Surgery Fellowship, Director, Philadelphia Hand Center; Director, Professor, Department of Orthopedic Surgery, Division of Hand Surgery, University Hospital, Thomas Jefferson University

Disclosure: Nothing to disclose.

References
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Lateral radiograph of a Rolando fracture. Note how the comminution is not easily viewed on this film.
Lateral tomograph of a Rolando fracture clearly shows the varus angulation at the fracture, as well as the multiple fragments of the articular surface.
Anteroposterior tomograph of a Rolando fracture further emphasizes the extent of comminution of the articular surface (same patient as in Image above).
Radiograph of a healed Rolando fracture following fixation of the articular surface and neutralization with a small plate.
 
 
 
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