Interobserver Variability in the Treatment of Little Finger Metacarpal Neck Fractures
Version 3 2024-10-19, 23:51
Version 2 2024-06-03, 20:39
Version 1 2015-04-23, 16:43
journal contribution
posted on 2024-10-19, 23:51 authored by Rick Tosti, Asif M Ilyas, Jos J Mellema, Thierry G Guitton, David Ring, AB Spoor, AB Shafritz, A Platz, A Berner, AL Terrono, A Jubel, BE Kreis, BF Hearon, CA Bottke, H Broekhuyse, R Buckley, B Watkins, CH Fernandes, C Metzger, C Taleb, LC Bainbridge, C Cornell, DFP Van Deurzen, DA Osei, D Haverkamp, DO Oloruntoba, D Eygendaal, DOF Verbeek, DM Kalainov, D Polatsch, P Melvanki, M Shafi, R Van Riet, D Ruchelsman, SF Duncan, E Stojkovska Pemovska, ET Tolo, ED Schumer, F Frihagen, FJ Raia, G DeSilva, GSM Dyer, GK Frykman, G Kontakis, R Gaston, G Garrigues, GR Hernandez, HW Grunwald, GW Balfour, M Nancollas, C Young, GM Pess, H Durchholz, K Erol, J Biert, J Choueka, JM Wolf, JN Doornberg, KJ Ponsen, S Kakar, K Eng, K Jeray, K Lee, KM Rumball, K Kabir, GA Kraan, LMSJ Poelhekke, M Ladislav, L Weiss, LC Borris, L Paz, M Mormino, M Bonczar, EM Hammerberg, M Kastelec, M Calcagni, AD Mazzocca, M Darowish, RM Costanzo, MI Abdel-Ghany, M Baskies, M Patel, M Prayson, M Tyllianakis, N Elias, NL Shortt, NL Leung, NK Kanakaris, R Omid, E Forigua Jaime, PRG Brink, P Kloen, PV Van Eerten, P Lygdas, P Benhaim, F García, L Guenter, R Haverlag, R Liem, RM Smith, Richard PageRichard Page, A Schmidt, S Mitchell, S Dodds, BM Nolan, S Moghtaderi, T Siff, T Begue, T Hughes, TG Stackhouse, T Tosounidis, V Philippe, CJ Wall, WC Hammert, Y Weil, W Satora, J Fischer, AL Van Der Zwan, J Adams, AE Garcia, AJH Vochteloo, A Barquet, A Kristan, HB Bamberger, MPJ Van Den Bekerom, WD Belangero, WT Benjamin, FL Walter, M Boyer, BPD Wills, RP Calfee, C Ekholm, C Swigart, C Cassidy, CD Oliveira Miranda, CJ Wilson, J Moreta-Suarez, C Wilson, CL Moreno-Serrano, C Manke, CM Jones, C Klostermann, GJ Della Rocca, CJ Barreto, M Merchant, D Brilej, N Bijlani, DM Silva, E Harvey, ET Walbeehm, F Suarez, F Lopez-Gonzalez, GC Caro, C Garnavos, GS Athwal, GC Babis, G Kohut, G Gradl, GM Huemer, CA Goldfarb, GJ Bayne, LAB Campinhos, AP Gutow, SC Marczyk, LB Lane, H Goost, HA Villamizar, E Hofmeister, I McGraw, JC Goslings, JF Di Giovanni, JM Abzug, J McAuliffe, J Isaacs, J Itamura, JM Conflitti, J Munyak, J Nolla, JH Scheer, JM Erickson, J Wint, K Chivers, DK Kirkpatrick, KJ Malone, K Dickson, LE Adolfsson, MAJ Van De Sande, MJ Richard, M Menon, M Soong, MM Wood, M Quell, M Behrman, MW Kessler, MJ Palmer, M Pirpiris, MW Grafe, N Schep, DL Nelson, N Wilson, JT Capo, J Calandruccio, OM Semenkin, CJH Veillette, M Richardson, P Inna, P Althausen, PA Martineau, P Blazar, P Hahn, P Schandelmaier, P Guidera, P Jebson, WA Batson, R De Bedout, R Shatford, S Rowinski, RM Fricker, R Hauck, R Wallensten, R Papandrea, RS Gilbert, M Rizzo, RL Hutchison, RD Zura, R Cardoso, R Pesantez, S Spruijt, SA Kennedy, S Mehta, S Beldner, S Kaplan, SG Kaar, SA Meylaerts, PN Streubel, T Omara, M Swiontkowski, T Gosens, T DeCoster, T Baxamusa, T Dienstknecht, FTD Kaplan, T Higgins, T Mittlmeier, T Apard, TJ Fischer, T Havliček, T Wyrick, V Giordano, V Neuhaus, VS Nikolaou, T Wright, C ZalavrasPurpose 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.
