radiograph imaging can be difficult to interpret and at times will require CT scan to fully characterize the injury Minimally or nondisplaced fractures are generally managed with a splint or cast Displaced fractures often require closed reduction, possible pinning, and subsequent casting Carpometacarpal dislocations alone or in conjunction with a base fracture are unstable and often require operative stabilization ( Fig 109.14 ) Bennett fractures, or intra-articular fractures of the base of the thumb metacarpal, mandate special attention, as the thumb carpometacarpal joint is critical for full use of this digit ( Fig 109.15 ) Similarly, Rolando fractures, comminuted fractures of the base of the thumb metacarpal, also require careful attention These fractures can be addressed temporarily with a thumb spica splint and timely referral CARPALS CLINICAL PEARLS AND PITFALLS The scaphoid is the most commonly fractured carpal bone Ligamentous injuries and dislocations can be subtle but have significant morbidity