Difference Between Bennett and Rolando Fracture

Bennett and Rolando fractures are two common types of thumb fractures that have a significant impact on hand function, affecting the thumb’s crucial role in grip and dexterity.

Both involve the base of the first metacarpal, but they differ in their characteristics, mechanisms of injury, and treatment approaches.

Comparative Overview

Below is the difference between Bennett Fracture and Rolando Fracture in tabular format.

Feature Bennett Fracture Rolando Fracture
Fracture Type Single, oblique fracture-dislocation Comminuted, intra-articular fracture
Mechanism of Injury Axial load on partially flexed thumb High-energy trauma
Fragment Characteristics Small fragment at metacarpal base Multiple fragments forming "Y" or "T"
Clinical Presentation Pain, swelling, limited motion Severe pain, swelling, deformity
Common Treatment Options Closed reduction, percutaneous pinning, ORIF External fixation, ORIF, arthrodesis
Prognosis Generally good, some stiffness possible Guarded, higher risk of arthritis

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Bennett Fracture

A Bennett fracture is a fracture-dislocation of the base of the first metacarpal (The bone connecting the thumb to the wrist) involving the CMC joint. It is typically characterized by a single, oblique fracture line that separates a small fragment of the metacarpal base, which remains attached to the trapezium by the volar beak ligament.

Cause Of injury

Bennett fractures usually occur due to a forceful axial load applied to a partially flexed thumb.

Common situations include:

  •  Sports injuries (e.g., falling onto an outstretched hand while gripping an object) 
  •  Direct trauma (e.g., punching).


  • Pain and swelling at the base of the thumb
  • Difficulty in Movement
  • Visible deformity or angulation


Bennett fractures often require surgical procedures to restore joint congruity and stability. Treatment options include:

  • Closed Reduction and Percutaneous Pinning: Aligning the fracture manually and inserting pins to maintain alignment.
  • Open Reduction and Internal Fixation (ORIF): Surgically exposing the fracture site to directly visualise and fixate the bones using screws and plates.


With appropriate treatment, patients can expect a good outcome, but some stiffness and arthritis risk may persist.



Rolando Fracture

It is an intra-articular three-part or comminuted fracture of the base of the first metacarpal. It consists of multiple fracture fragments, typically forming a "Y" or "T" shape.

Cause of injury

  • Severe pain and swelling at the base of the thumb
  • Noticeable deformity
  • Significant loss of thumb motion


Since its complex surgical treatment is almost always necessary. Options include:

  • External Fixation: Stabilising the fracture with an external frame.
  • ORIF: Aligning and fixing the multiple fragments with screws and plates.
  • Arthrodesis: Fusing the joint in severe cases to relieve pain and maintain stability.


Rolando fractures have a more guarded prognosis compared to Bennett fractures due to the complexity of the injury and higher risk of post-traumatic arthritis and stiffness.

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Similarities and differences between Bennett and Rolando


  • Location: Both involve the base of the first metacarpal.
  • Mechanism: Typically result from high-energy trauma.
  • Symptoms: Pain, swelling, limited thumb motion.
  • Diagnosis: Physical examination, X-rays, and sometimes CT scans.
  • Treatment: Often requires surgical intervention.


  • Fracture Type: Bennett is a single oblique fracture-dislocation; Rolando is a comminuted intra-articular fracture.
  • Fragment Pattern: Bennett has a single fragment; Rolando has multiple fragments forming "Y" or "T" shapes.


Bennett generally has a better prognosis with less risk of arthritis; Rolando has a more guarded prognosis.

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How are Rolando fractures typically treated?

Rolando fractures are usually treated with surgical interventions such as external fixation, ORIF, or in severe cases, arthrodesis (joint fusion).

What treatment options are available for Bennett fractures?

Treatment options include closed reduction and percutaneous pinning or open reduction and internal fixation (ORIF) to restore joint congruity and stability.

What are the common symptoms of Bennett and Rolando fractures?

Symptoms include pain, swelling, limited thumb motion, and visible deformity at the base of the thumb.

How do Bennett and Rolando fractures commonly occur?

Both fractures typically result from high-energy trauma, such as a direct blow to the thumb or a forceful axial load applied to a partially flexed thumb.

What is the primary difference between a Bennett fracture and a Rolando fracture?

A Bennett fracture is a single oblique fracture-dislocation of the base of the first metacarpal, while a Rolando fracture is a comminuted, intra-articular fracture with multiple fragments forming a "Y" or "T" shape.