This review covers fractures of the base of the first metacarpal — including extra-articular, Bennett, Rolando, and severely comminuted patterns — examining their anatomy, deforming forces, classification, and treatment options to guide fracture-specific decision-making.
When you see an intra-articular fracture at the thumb metacarpal base, your reduction goal is ≤1 mm of articular stepoff — anything more roughly doubles the rate of symptomatic outcomes at medium-term follow-up.
Let fragment size and soft-tissue status drive your fixation choice: large Rolando fragments get ORIF with a T-plate, small fragments get external fixation or oblique traction.
This review covers fractures of the base of the first metacarpal — including extra-articular, Bennett, Rolando, and severely comminuted patterns — examining their anatomy, deforming forces, classification, and treatment options to guide fracture-specific decision-making.
When you see an intra-articular fracture at the thumb metacarpal base, your reduction goal is ≤1 mm of articular stepoff — anything more roughly doubles the rate of symptomatic outcomes at medium-term follow-up.
Let fragment size and soft-tissue status drive your fixation choice: large Rolando fragments get ORIF with a T-plate, small fragments get external fixation or oblique traction.