Atif Rafique, Hyder Ali, Moiz Sadiq, Shahab Ghani, Intisar Ahmed Siddiqui.
Gender difference in metacarpal descent of fifth metacarpal.
J Coll Physicians Surg Pak Jan ;16(7):479-82.

Objective: To determine the difference in metacarpal descent of fifth metacarpal between men and women. Study Design: Descriptive study. Place and Duration: The outpatient department of plastic, reconstructive and hand surgery at Liaquat National Hospital, Karachi, from August 2005 to February 2006. Patients and Methods: Skyline of the 2nd and 3rd metacarpals were used as reference line, from which the descent of the 5th metacarpal head was measured. The position of 5th metacarpal head was documented as angle X. Metacarpal descent was defined as the difference between angle "X" in relaxed and clenched fist position. The relaxed position was standardized by placing the forearm, wrist and palm on a shaped woodblock such that the wrist would be held in 25 - 30 degree in extension by a triangular spur, supported the 3rd metacarpal only. It was ensured that the movement of 4th and 5th metacarpals were not impaired. Analysis of variance was performed to compare the significance of means between genders at p < 0.05 level of significance. Results: Metacarpal descent of the 5th metacarpal of both hands was significantly greater for women, with a mean of 7 degree as compared with a mean of 4 degree for the men. This decrease in angle "X" was significant for the right 5th metacarpal relaxed and fist position and the fist position on the left. In contrast, women showed no significant differences between the various age groups for any of the variables tested.There was no relationship between metacarpal descent and hand dominance. Conclusion: Difference in metacarpal descent between men and women is significant and must be kept in mind when hand function is evaluated in both genders to assess the outcome of treatment and rehabilitation.

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