Bennett and Rolando Fractures of the Thumb

📧 EM Note Newsletter https://forms.gle/8boToiKDXVE3V8U19 Signup to get free weekly PDF via email. PS: Please join our membership for more perks (members can request for specific PDF file by posting in the EM Note YouTube Membership section). Homepage: EMNote.org ■ 🚩Membership: https://tinyurl.com/joinemnote 🚩ACLS Lecture: https://tinyurl.com/emnoteacls Bennett and Rolando Fractures of the Thumb Thumb metacarpal base fractures impact ~50% of hand function Two main intra-articular fractures: Bennett fracture Rolando fracture Correct differentiation critical for treatment & prognosis Bennett Fracture Location: Intra-articular, base of 1st metacarpal (CMC joint) Pattern: Two-part oblique fracture Palmar-ulnar fragment + displaced metacarpal shaft Mechanism: Axial force on partially flexed thumb (e.g., punch, fall) Radiology: Two fragments, often displaced Stability: Unstable (abductor pollicis longus pulls shaft) Rolando Fracture Location: Intra-articular, base of 1st metacarpal (CMC joint) Pattern: Comminuted (≥3 fragments), Y- or T-shaped Mechanism: High-energy axial load Radiology: Multi-fragmentary, complex Stability: Highly unstable, poor prognosis Clinical Pearls Bennett: Think two pieces – oblique fracture, CMC subluxation Rolando: Think multiple pieces – comminuted, "shattered" base Both require urgent orthopedic referral Bennett and Rolando Fractures Bennett: Simpler, better outcomes Rolando: Complex, higher complication risk Early diagnosis → optimal treatment