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

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

doi:10.1016/j.rboe.2016.02.009

Acessibilidade / Reportar erro

Brasil

Revista Brasileira de Ortopedia

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original Article • Rev. bras. ortop. 51 (2) • Mar-Apr 2016 • https://doi.org/10.1016/j.rboe.2016.02.009 copy

What is the real angle of deviation of metacarpal neck fractures on oblique views? A radiographic study^☆ ☆ Work performed in the Department of Orthopedics and Traumatology, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

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.

METHODS:

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.

RESULTS:

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.

CONCLUSIONS:

Oblique radiographs at 30° 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.

Fractures, bone; Hand; Metacarpus; Radiography

Angle of fracture	Rotation of metacarpal
	0 (L)	15°	30°	45°	60°	75°	90° (AP)
16°	16	15	15	12	9	5	0
29°	29	28	27	23	19	11	0
43.6°	43.6	43	40	34	25	14	0
58°	58	58	54	49	39	25	0
74°	74	73	71	64	57	38	0
89°	89	88	87	84	80	69	0

Angle of fracture	Rotation of metacarpal
	0 (L)	15°	30°	45°	60°	75°	90° (AP)
16°	16	15	14	11	8	4	0
29°	29	28	26	21	15	8	0
43.6°	43.6	43	40	34	25	14	0
58°	58	57	54	49	39	22	0
74°	74	73	72	68	60	42	0
89°	89	89	89	89	88	86	0

Measured angle (in degrees)	Rotation of the hand (in degrees)
	0	5	10	15	20	25	30	35	40	45	50	55	60	65	70	75	80	85	90
5	5	5	5	5	5	6	6	6	7	7	8	9	10	12	14	19	27	45	90
10	10	10	10	10	11	11	12	12	13	14	15	17	19	23	27	34	45	64	90
15	15	15	15	16	16	16	17	18	19	21	23	25	28	32	38	46	57	72	90
20	20	20	20	21	21	22	23	24	25	27	30	32	36	41	47	55	64	77	90
25	25	25	25	26	26	27	28	30	31	33	36	39	43	48	54	61	70	79	90
30	30	30	30	31	32	32	34	35	37	39	42	45	49	54	59	66	73	81	90
35	35	35	35	36	37	38	39	41	42	45	47	51	54	59	64	70	76	83	90
40	40	40	40	41	42	43	44	46	48	50	53	56	59	63	68	73	78	84	90
45	45	45	45	46	47	48	49	51	53	55	57	60	63	67	71	75	80	85	90
50	50	50	50	51	52	53	54	55	57	59	62	64	67	70	74	78	82	86	90
55	55	55	55	56	57	58	59	60	62	64	66	68	71	74	77	80	83	87	90
60	60	60	60	61	62	62	63	65	66	68	70	72	74	76	79	82	84	87	90
65	65	65	65	66	66	67	68	69	70	72	73	75	77	79	81	83	85	88	90
70	70	70	70	71	71	72	73	73	74	76	77	78	80	81	83	85	86	88	90
75	75	75	75	75	76	76	77	78	78	79	80	81	82	84	85	86	87	89	90
80	80	80	80	80	81	81	81	82	82	83	84	84	85	86	87	87	88	89	90
85	85	85	85	85	85	85	86	86	86	86	87	87	87	88	88	89	89	90	90
90	90	90	90	90	90	90	90	90	90	90	90	90	90	90	90	90	90	90	90

Angle of distal fragment	Rotation of metacarpal
	0	15°	30°	45°	60°	75°	90° (F)
16°	100%	94%	94%	75%	56%	31%	0%
29°	100%	97%	93%	79%	66%	38%	0%
43°	100%	98%	91%	78%	58%	32%	0%
58°	100%	100%	93%	84%	67%	43%	0%
74°	100%	99%	96%	86%	77%	51%	0%
89°	100%	99%	98%	94%	90%	78%	0%

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] * Corresponding author. E-mail: ribeiroesc@yahoo.com.br (A. de Góes Ribeiro).

Measured angle (in degrees)	Rotation of the hand (in degrees)
	0	5	10	15	20	25	30	35	40	45	50	55	60	65	70	75	80	85	90
5	5	5	5	5	5	6	6	6	7	7	8	9	10	12	14	19	27	45	90
10	10	10	10	10	11	11	12	12	13	14	15	17	19	23	27	34	45	64	90
15	15	15	15	16	16	16	17	18	19	21	23	25	28	32	38	46	57	72	90
20	20	20	20	21	21	22	23	24	25	27	30	32	36	41	47	55	64	77	90
25	25	25	25	26	26	27	28	30	31	33	36	39	43	48	54	61	70	79	90
30	30	30	30	31	32	32	34	35	37	39	42	45	49	54	59	66	73	81	90
35	35	35	35	36	37	38	39	41	42	45	47	51	54	59	64	70	76	83	90
40	40	40	40	41	42	43	44	46	48	50	53	56	59	63	68	73	78	84	90
45	45	45	45	46	47	48	49	51	53	55	57	60	63	67	71	75	80	85	90
50	50	50	50	51	52	53	54	55	57	59	62	64	67	70	74	78	82	86	90
55	55	55	55	56	57	58	59	60	62	64	66	68	71	74	77	80	83	87	90
60	60	60	60	61	62	62	63	65	66	68	70	72	74	76	79	82	84	87	90
65	65	65	65	66	66	67	68	69	70	72	73	75	77	79	81	83	85	88	90
70	70	70	70	71	71	72	73	73	74	76	77	78	80	81	83	85	86	88	90
75	75	75	75	75	76	76	77	78	78	79	80	81	82	84	85	86	87	89	90
80	80	80	80	80	81	81	81	82	82	83	84	84	85	86	87	87	88	89	90
85	85	85	85	85	85	85	86	86	86	86	87	87	87	88	88	89	89	90	90
90	90	90	90	90	90	90	90	90	90	90	90	90	90	90	90	90	90	90	90

Measured angle (in degrees)	Rotation of the hand (in degrees)
	0	5	10	15	20	25	30	35	40	45	50	55	60	65	70	75	80	85	90
5	5	5	5	5	5	6	6	6	7	7	8	9	10	12	14	19	27	45	90
10	10	10	10	10	11	11	12	12	13	14	15	17	19	23	27	34	45	64	90
15	15	15	15	16	16	16	17	18	19	21	23	25	28	32	38	46	57	72	90
20	20	20	20	21	21	22	23	24	25	27	30	32	36	41	47	55	64	77	90
25	25	25	25	26	26	27	28	30	31	33	36	39	43	48	54	61	70	79	90
30	30	30	30	31	32	32	34	35	37	39	42	45	49	54	59	66	73	81	90
35	35	35	35	36	37	38	39	41	42	45	47	51	54	59	64	70	76	83	90
40	40	40	40	41	42	43	44	46	48	50	53	56	59	63	68	73	78	84	90
45	45	45	45	46	47	48	49	51	53	55	57	60	63	67	71	75	80	85	90
50	50	50	50	51	52	53	54	55	57	59	62	64	67	70	74	78	82	86	90
55	55	55	55	56	57	58	59	60	62	64	66	68	71	74	77	80	83	87	90
60	60	60	60	61	62	62	63	65	66	68	70	72	74	76	79	82	84	87	90
65	65	65	65	66	66	67	68	69	70	72	73	75	77	79	81	83	85	88	90
70	70	70	70	71	71	72	73	73	74	76	77	78	80	81	83	85	86	88	90
75	75	75	75	75	76	76	77	78	78	79	80	81	82	84	85	86	87	89	90
80	80	80	80	80	81	81	81	82	82	83	84	84	85	86	87	87	88	89	90
85	85	85	85	85	85	85	86	86	86	86	87	87	87	88	88	89	89	90	90
90	90	90	90	90	90	90	90	90	90	90	90	90	90	90	90	90	90	90	90

Brasil

Brasil

What is the real angle of deviation of metacarpal neck fractures on oblique views? A radiographic study☆ ☆ Work performed in the Department of Orthopedics and Traumatology, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil.

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSIONS:

What is the real angle of deviation of metacarpal neck fractures on oblique views? A radiographic study^☆ ☆ Work performed in the Department of Orthopedics and Traumatology, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil.

Measured angle (in degrees)	Rotation of the hand (in degrees)
	0	5	10	15	20	25	30	35	40	45	50	55	60	65	70	75	80	85	90
5	5	5	5	5	5	6	6	6	7	7	8	9	10	12	14	19	27	45	90
10	10	10	10	10	11	11	12	12	13	14	15	17	19	23	27	34	45	64	90
15	15	15	15	16	16	16	17	18	19	21	23	25	28	32	38	46	57	72	90
20	20	20	20	21	21	22	23	24	25	27	30	32	36	41	47	55	64	77	90
25	25	25	25	26	26	27	28	30	31	33	36	39	43	48	54	61	70	79	90
30	30	30	30	31	32	32	34	35	37	39	42	45	49	54	59	66	73	81	90
35	35	35	35	36	37	38	39	41	42	45	47	51	54	59	64	70	76	83	90
40	40	40	40	41	42	43	44	46	48	50	53	56	59	63	68	73	78	84	90
45	45	45	45	46	47	48	49	51	53	55	57	60	63	67	71	75	80	85	90
50	50	50	50	51	52	53	54	55	57	59	62	64	67	70	74	78	82	86	90
55	55	55	55	56	57	58	59	60	62	64	66	68	71	74	77	80	83	87	90
60	60	60	60	61	62	62	63	65	66	68	70	72	74	76	79	82	84	87	90
65	65	65	65	66	66	67	68	69	70	72	73	75	77	79	81	83	85	88	90
70	70	70	70	71	71	72	73	73	74	76	77	78	80	81	83	85	86	88	90
75	75	75	75	75	76	76	77	78	78	79	80	81	82	84	85	86	87	89	90
80	80	80	80	80	81	81	81	82	82	83	84	84	85	86	87	87	88	89	90
85	85	85	85	85	85	85	86	86	86	86	87	87	87	88	88	89	89	90	90
90	90	90	90	90	90	90	90	90	90	90	90	90	90	90	90	90	90	90	90