Evaluation of Metacarpal Compression Test for Diagnosis of Metacarpal Fracture

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.