Rolando Fracture Workup

Updated: Jul 09, 2019
  • Author: John J Walsh, IV, MD; Chief Editor: Harris Gellman, MD  more...
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Workup

Imaging Studies

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

Lateral radiograph of a Rolando fracture. Note how Lateral 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, and computed tomography (CT). (See the images below.)

Lateral tomograph of a Rolando fracture clearly sh 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 fu Anteroposterior 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 with regard to open reduction versus external fixation.