Radiographic assessment of metacarpal shortening after nonoperative and operative treatment of spiral and oblique metacarpal shaft fractures.
Cecilia Stalberg Ostwald, Fredrik Peyronson, Nils P Hailer et al.
✦ AI-curated · Sources linked
In 30 seconds
This radiographic follow-up of a randomised controlled trial compared metacarpal shortening after nonoperative or operative treatment of spiral or oblique shaft fractures. It included 33 patients assessed at a mean of 4.5 years: 17 had unrestricted mobilisation without surgery and 16 underwent surgery. Mean shortening was 3.9 mm after nonoperative treatment and 0.9 mm after operative treatment, a mean difference of 3 mm (p < 0.001). Extension deficit, cosmesis and overall satisfaction were similar between groups. The Shortening Absolute measurement method showed substantial to excellent reliability.
Key findings
- Mean shortening was 3.9 mm after nonoperative treatment versus 0.9 mm after operative treatment; mean difference 3 mm (p < 0.001).
- Extension deficit, cosmesis and overall satisfaction were similar between treatment groups.
- The Shortening Absolute method showed substantial to excellent intra- and interrater reliability.
Why it matters
The findings quantify the greater radiographic shortening associated with nonoperative treatment while showing that measured shortening did not correspond to differences in extension deficit, cosmesis or satisfaction in this follow-up. A reproducible measurement method may also help make radiographic comparisons across studies more consistent.
What to keep in mind
The follow-up included 33 patients from a previous trial, and the reported outcomes do not establish whether shortening affects hand function more broadly.