title: Interobserver variability in the treatment of little finger metacarpal neck fractures.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Diagnostic III.
authors.affiliation: Department of Orthopaedic Surgery and Sports Medicine, Temple University School of Medicine; the Rothman Institute, Thomas Jefferson University, Philadelphia, PA; Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA. Electronic address: rtosti@temple.edu.
authors.forename: Rick
authors.initials: R
authors.lastname: Tosti
authors.affiliation: Department of Orthopaedic Surgery and Sports Medicine, Temple University School of Medicine; the Rothman Institute, Thomas Jefferson University, Philadelphia, PA; Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA.
authors.forename: Asif M
authors.initials: AM
authors.lastname: Ilyas
authors.affiliation: Department of Orthopaedic Surgery and Sports Medicine, Temple University School of Medicine; the Rothman Institute, Thomas Jefferson University, Philadelphia, PA; Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA.
authors.forename: Jos J
authors.initials: JJ
authors.lastname: Mellema
authors.affiliation: Department of Orthopaedic Surgery and Sports Medicine, Temple University School of Medicine; the Rothman Institute, Thomas Jefferson University, Philadelphia, PA; Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA.
authors.forename: Thierry G
authors.initials: TG
authors.lastname: Guitton
authors.affiliation: Department of Orthopaedic Surgery and Sports Medicine, Temple University School of Medicine; the Rothman Institute, Thomas Jefferson University, Philadelphia, PA; Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA.
authors.forename: David
authors.initials: D
authors.lastname: Ring
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005383:Finger Injuries / Q000000981:diagnostic imaging* / Q000601:surgery*; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D008297:Male; D008663:Metacarpus / Q000000981:diagnostic imaging* / Q000293:injuries*; D008875:Middle Aged; D015588:Observer Variation; D010818:Practice Patterns, Physicians'; D011859:Radiography; D011897:Random Allocation
keywords: Boxer fracture; interobserver agreement; little finger; metacarpal; variability