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 HPI- 55 year male presents to the ED c/o left thumb
pain after punching a police officer in his bullet proof
vest.
 PMX- HIV, DM
 Allergies- Codeine
 Meds- Non currently
 Social- Crack Cocaine
 P- 110- BP 160/80 RR 16 T- 98.8
 HEENT- NCAT
 Cardio- S1 S2
 Neuro- Intact
 Ext. Left elbow and forearm unremarkable. Upon
palpation there is pain and swelling noted at the
base of the 1st metacarpal. Distal pulses are intact
 Immobilization with a thumb spica
 Pain control
 Orthopedic referral
 Typically requires operative management
 Anatomy
 - involves 3 part fx at base of metacarpal;
- inaddition to volar lip fx, as seen with a Bennett fx,
there is also large dorsal fragment, resulting in Y or T
shaped intra-articular fx;
 - Fx is a comminuted intra-articular fx at base of thumb
metacarpal, even if Y or T is not present;

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Rolando Fracture Power Point

  • 1.
  • 2.  HPI- 55 year male presents to the ED c/o left thumb pain after punching a police officer in his bullet proof vest.  PMX- HIV, DM  Allergies- Codeine  Meds- Non currently  Social- Crack Cocaine
  • 3.  P- 110- BP 160/80 RR 16 T- 98.8  HEENT- NCAT  Cardio- S1 S2  Neuro- Intact  Ext. Left elbow and forearm unremarkable. Upon palpation there is pain and swelling noted at the base of the 1st metacarpal. Distal pulses are intact
  • 4.
  • 5.
  • 6.  Immobilization with a thumb spica  Pain control  Orthopedic referral  Typically requires operative management
  • 7.  Anatomy  - involves 3 part fx at base of metacarpal; - inaddition to volar lip fx, as seen with a Bennett fx, there is also large dorsal fragment, resulting in Y or T shaped intra-articular fx;  - Fx is a comminuted intra-articular fx at base of thumb metacarpal, even if Y or T is not present;