Evaluation of Metacarpal Compression Test for Diagnosis of Metacarpal Fracture

Mohamad Karimi, Naser; Mohyeddini, Mohsen; Zeinali, Faeze; Nikouyeh, Mehrnaz; Sobhan, Mohamadreza; Jafari, Mohamad Ai; Esmaeili, Alireza

doi:10.30491/tm.2020.217846.1064

Evaluation of Metacarpal Compression Test for Diagnosis of Metacarpal Fracture

Document Type : Original Article

Authors

Naser Mohamad Karimi ¹

Mohsen Mohyeddini ²

Faeze Zeinali ¹

Mehrnaz Nikouyeh ¹

Mohamadreza Sobhan ³

Mohamad Ai Jafari ¹

Alireza Esmaeili ¹

¹ Assistant Professor, Department of Emergency Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

² Assistant Professor, Department of Emergency Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran

³ Assistant Professor, Department of Orthopedic, Shahid Sadoughi University Of Medical Sciences, Yazd, Iran

10.30491/tm.2020.217846.1064

Abstract

Background: There are many methods for evaluating a traumatized metacarp.
Objectives: This study sought to evaluate the accuracy of the metacarpal compression test for the diagnosis of metacarpal fracture.
Methods: All patients with metacarpal trauma were tested via placement of axial load (compression) on the metacarpal; induction or exacerbation of pain on each metacarp was recorded upon applying axial pressure. Then, an X-Ray imaging system was used to identify and record the presence of fracture. All data were entered into a 2x2 table, and then negative predictive value (NPV), positive predictive value (PPV), sensitivity and specificity of the test were calculated.
Results: After careful physical examination and application of the axial pressure on the metacarpal bone, 16(23.68%) patients did not experience any pain during axial loading (none had fracture). According to the statistical analyses of the data, the proposed method had a 69% specificity, 100% sensitivity, 86% PPV and 100% NPV.
Conclusion: Our findings showed that axial loading applied on the metacarpal bone, when it leads to pain, is a good marker for fracture. On the other hand, patients with negative test results had no fracture on radiography, which emphasized 100% NPV of the test.

Keywords

Metacarpal Bone

Fracture

Compression Test

Clinical Decision Rule

Axial Load