Treatment of Rolando Fractures by Open Reduction and Internal Fixation using Mini T-Plate and Screws.

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Traumatology

Background:

• Rolando fractures are intra-articular fractures of the thumb's carpometacarpal joint.
• Incongruity can lead to significant disability, including loss of motion and secondary osteoarthritis.
• Current treatment guidelines for these fractures remain undefined.

Purpose of the Study:

• To evaluate the efficacy of open reduction and internal fixation (ORIF) using mini T-plates for Rolando fractures.
• To assess functional outcomes and complication rates associated with this surgical technique.

Main Methods:

• A series of nine Rolando fractures with large, single fragments underwent ORIF with mini T-plates and screws.
• Follow-up was conducted at a 3-year interval to assess fracture union and functional results.

Main Results:

• All nine fractures achieved union within the 3-year follow-up period.
• Excellent or good functional results were reported in the majority of patients.
• Patients successfully returned to their previous activities without significant complications like deep infection or loss of reduction.

Conclusions:

• ORIF with mini T-plates is a viable option for selected Rolando fractures with large articular fragments.
• This technique allows for direct visualization, removal of soft tissue interposition, and precise anatomical restoration.
• Early mobilization is feasible, potentially minimizing stiffness and future arthrosis, though the procedure demands precision and patient discussion regarding implant removal.