radER 3.2

rader new

Case

A 23-year-old man presents to the ED complaining of left thumb pain after he collided with another player during a rugby match. There is swelling and tenderness at the base of the thumb.  You think the patient may have sustained a fracture of his proximal thumb so you order radiographs.  One of the radiographs is seen below:

thumb 2

Questions

1. What is the eponym for this fracture?

2. What is the ED management for this fracture?

3. Is the prognosis better or worse than the fracture seen in radER 3.1

Please click on the “comments” link or post your answer in the “reply box”. You will not see your answer post until next week when all of the submitted answers will be posted. Good luck!

radER is a weekly contest consisting of a radiograph selected from various areas of emergency medicine that are central to the education of medical students and residents in training.

5 Responses

  1. Rolando Fracture

    Worse than Bennett Fracture

    ED Management: Thumb Spica and Surgical Consult

  2. 1. Rolando fx

    2. STAT hand consult…requires surgical managment either ORIF or external fixation

    3. The Rolando has a worse prognosis when compared to the Bennett fracture featured in radER3.1.

  3. 1. Rolando Fracture
    2. Thumb spica and rapid ortho F/U, usually requires ORIF (fragment amenable to pinning) or traction (comminuted).
    3. Worse

  4. 1) Gamekeeper’s thumb
    2) Closed reduction and thumb spica
    3) Better

  5. 1. Rolando Fracture
    2. Thumb Spica, Hand/Plastic surgical consultation
    3. Worse prognosis than Bennett

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