Treatment of Bennett, Rolando, and Vertical Intraarticular Trapezial Fractures

Abstract

Intraarticular fractures at the first trapeziometa-carpal joint include Bennett, Rolando, and vertical intraarticular fractures of the trapezium. If these fractures heal in a displaced position, a traumatic arthritis quickly develops at the thumb base. Open reduction and lag screw rigid internal fixation of a Bennett fracture is advisable if a satisfactory closed reduction cannot be obtained. If the palmar and dorsal displaced fragments of a Rolando fracture are of adequate size, an open reduction internal fixation may be performed with small lag screws incorporated through a T- or L-shaped buttress plate. A displaced vertical intraarticular fracture of the trapezium may be easily misdiagnosed as a trivial chip fracture, unless specific radiographic views are obtained. Open reduction internal fixation is the only treatment method that will provide a satisfactory outcome for this fracture.