What is the real angle of deviation of metacarpal neck fractures on oblique views? A radiographic study

Arthur de Góes Ribeiro, Daniel Hidalgo Gonçalez, João Manoel Fonseca Filho, Guilherme Marques da Fonseca, Antonio Carlos Costa, Ivan Chakkour

The aim of this study was to establish an indirect, easy-to-use, predictable and safe means of obtaining the true degree of displacement of fractures of the neck of the fifth metacarpal bone, through oblique radiographic views. An anatomical specimen from the fifth human metacarpal was dissected and subjected to ostectomy in the neck region. A 1-mm Kirschner wire was fixed to the base of the fifth metacarpal bone, perpendicular to the longitudinal axis of the bone and parallel to the ground. Another six Kirschner wires of the same diameter were bent over and attached to the ostectomized bone to simulate fracture displacement. Axial rotation of the metacarpus was used to create oblique radiographic views. Radiographic images were generated with different angles and at several degrees of rotation of the bone. We deduced a mathematical formula that showed the true displacement of fractures of the neck of the fifth metacarpal bone by means of oblique radiographs. Oblique radiographs at 30̊ of supination provided the best view of the bone and least variation from the real value of the displacement of fractures of the fifth metacarpal bone. The mathematical formula deduced was concordant with the experimental model used.