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J Hand Surg Am. 2014 Sep;39(9):1722-7. doi: 10.1016/j.jhsa.2014.05.023. Epub 2014 Jul 14.

Interobserver variability in the treatment of little finger metacarpal neck fractures.

Collaborators (248)

Spoor AB, Shafritz AB, Platz A, Berner A, Terrono AL, Jubel A, Kreis BE, Hearon BF, Bottke CA, Broekhuyse H, Buckley R, Watkins B, Fernandes CH, Metzger C, Taleb C, Bainbridge LC, Cornell C, van Deurzen DF, Osei DA, Haverkamp D, Oloruntoba DO, Eygendaal D, Verbeek DO, Kalainov DM, Polatsch D, Melvanki P, Shafi M, van Riet R, Ruchelsman D, Duncan SF, Pemovska ES, Tolo ET, Schumer ED, Frihagen F, Raia FJ, DeSilva G, Dyer GS, Frykman GK, Kontakis G, Gaston R, Garrigues G, Hernandez GR, Grunwald HW, Balfour GW, Nancollas M, Young C, Pess GM, Durchholz H, Erol K, Biert J, Choueka J, Wolf JM, Doornberg JN, Ponsen KJ, Kakar S, Eng K, Jeray K, Lee K, Rumball KM, Kabir K, Kraan GA, Poelhekke LM, Ladislav M, Weiss L, Borris LC, Paz L, Mormino M, Bonczar M, Hammerberg EM, Kastelec M, Calcagni M, Mazzocca AD, Darowish M, Costanzo RM, Abdel-Ghany MI, Baskies M, Patel M, Prayson M, Tyllianakis M, Elias N, Shortt NL, Leung NL, Kanakaris NK, Omid R, Forigua Jaime E, Brink PR, Kloen P, Van Eerten PV, Lygdas P, Benhaim P, García F, Guenter L, Haverlag R, Liem R, Smith RM, Page RS, Schmidt A, Mitchell S, Dodds S, Nolan BM, Moghtaderi S, Siff T, Begue T, Hughes T, Stackhouse TG, Tosounidis T, Philippe V, Wall CJ, Hammert WC, Weil Y, Satora W, Fischer J, van der Zwan AL, Adams J, Garcia AE, Vochteloo AJ, Barquet A, Kristan A, Bamberger HB, van den Bekerom MP, Belangero WD, Benjamin WT, Walter FL, Boyer M, Wills BP, Calfee RP, Ekholm C, Swigart C, Cassidy C, Oliveira Miranda CD, Wilson CJ, Moreta-Suarez J, Wilson C, Moreno-Serrano CL, Manke C, Jones CM, Klostermann C, Della Rocca GJ, Barreto CJ, Merchant M, Brilej D, Bijlani N, Silva DM, Harvey E, Walbeehm ET, Suarez F, Lopez-Gonzalez F, Caro GC, Garnavos C, Athwal GS, Babis GC, Kohut G, Gradl G, Huemer GM, Goldfarb CA, Bayne GJ, Campinhos LA, Gutow AP, Marczyk SC, Lane LB, Goost H, Villamizar HA, Hofmeister E, McGraw I, Goslings JC, Di Giovanni JF, Abzug JM, McAuliffe J, Isaacs J, Itamura J, Conflitti JM, Munyak J, Nolla J, Scheer JH, Erickson JM, Wint J, Chivers K, Kirkpatrick DK, Malone KJ, Dickson K, Adolfsson LE, Van de Sande MA, Richard MJ, Menon M, Soong M, Wood MM, Quell M, Behrman M, Kessler MW, Palmer MJ, Pirpiris M, Grafe MW, Schep N, Nelson DL, Wilson N, Capo JT, Calandruccio J, Semenkin OM, Veillette CJ, Richardson M, Inna P, Althausen P, Martineau PA, Blazar P, Hahn P, Schandelmaier P, Guidera P, Jebson P, Batson WA, de Bedout R, Shatford R, Rowinski S, Fricker RM, Hauck R, Wallensten R, Papandrea R, Gilbert RS, Rizzo M, Hutchison RL, Zura RD, Cardoso R, Pesantez R, Spruijt S, Kennedy SA, Mehta S, Beldner S, Kaplan S, Kaar SG, Meylaerts SA, Streubel PN, Omara T, Swiontkowski M, Gosens T, DeCoster T, Baxamusa T, Dienstknecht T, Kaplan FT, Higgins T, Mittlmeier T, Apard T, Fischer TJ, Havliček T, Wyrick T, Giordano V, Neuhaus V, Nikolaou VS, Wright T, Zalavras C.

Abstract

PURPOSE:

To address the null hypothesis that surgeons shown radiographs of little finger metacarpal neck fractures with measured fracture angulation would recommend surgery as often as surgeons shown unmarked radiographs.

METHODS:

Members of the Science of Variation Group, an international collaboration of fully trained orthopedic and trauma surgeons, were asked to review 20 little finger metacarpal neck fracture cases, which included a vignette and 3 high-quality radiographs. Members were then randomized to review radiographs with or without measured fracture angulation on the lateral view and select operative or nonoperative management.

RESULTS:

Surgeons shown radiographs with measured angulation were more likely to recommend surgery, and there was less variability among these surgeons, particularly for fractures with less angular deformity.

CONCLUSIONS:

Measured fracture angulation has a small but significant influence on treatment recommendations for little finger metacarpal neck fractures.

TYPE OF STUDY/LEVEL OF EVIDENCE:

Diagnostic III.

Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

KEYWORDS:

Boxer fracture; interobserver agreement; little finger; metacarpal; variability

[PubMed - indexed for MEDLINE]
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