{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:11:26Z","timestamp":1791267086768,"version":"4.1.0"},"reference-count":22,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T00:00:00Z","timestamp":1749686400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T00:00:00Z","timestamp":1749686400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hand (New York, N,Y.)"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Distal radius fractures represent a significant cause of morbidity and loss of independence, particularly in older patients. There is no good consensus on which fractures managed nonoperatively will be unstable in a cast or splint other than Lafontaine criteria, the only relevant clinical study to date. Second metacarpal cortical percentage (2MCP) has been shown to be a reliable predictor of osteoporosis and poor bone quality. This study investigates the utility of 2MCP as an independent predictor of fracture displacement in nonoperative fracture management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective cohort of distal radius fractures treated conservatively over 7 years (2013-2020) was investigated. Injury, postreduction, and 4-week follow-up radiographs were reviewed for 2MCP, volar tilt, ulnar variance, and other demographic factors. Multivariate regression analysis was used to predict fracture displacement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Only 2MCP and initial fracture displacement were associated with displacement at 4 weeks (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .008,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .008). Other than initial fracture displacement, Lafontaine criteria were not associated with radiographic outcomes. A 2MCP threshold of 53.5% optimized sensitivity (67.5%) and specificity (70.2%) in predicting 10\u00b0 of fracture displacement (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .003). A 2MCP threshold of 49.5% was 86.7% sensitive and 74.7% specific at detecting dorsal malunion (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .032).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Second metacarpal cortical percentage is a useful clinical tool in predicting distal radius fracture instability. Clinicians can use 2MCP both in guiding decision-making when selecting patients who may benefit from operative management and as a screening tool for osteoporosis and initiation of antiresorptive therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15589447251346859","type":"journal-article","created":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T07:13:51Z","timestamp":1749712431000},"page":"1032-1037","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Rethinking Lafontaine Criteria: Second Metacarpal Cortical Percentage as a Reliable Predictor of Distal Radius Fracture Instability"],"prefix":"10.1177","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1240-6839","authenticated-orcid":false,"given":"Clinton J.","family":"Ulmer","sequence":"first","affiliation":[{"name":"The University of Texas Health Science Center at San Antonio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7946-4059","authenticated-orcid":false,"given":"Luke","family":"Verlinsky","sequence":"additional","affiliation":[{"name":"The University of Texas Health Science Center at San Antonio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chimobi C.","family":"Emukah","sequence":"additional","affiliation":[{"name":"The University of Texas Health Science Center at San Antonio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5138-8856","authenticated-orcid":false,"given":"Mallory J.","family":"Ogburn","sequence":"additional","affiliation":[{"name":"The University of Texas Health Science Center at San Antonio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan","family":"Ubanwa","sequence":"additional","affiliation":[{"name":"The University of Texas Health Science Center at San Antonio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6165-9915","authenticated-orcid":false,"given":"Brian W.","family":"Sager","sequence":"additional","affiliation":[{"name":"The University of Texas Health Science Center at San Antonio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,6,12]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hcl.2012.02.001"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.H.00486"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-019-09531-z"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a116314"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1080\/00016470310013743"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2003.09.016"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0020-1383(89)90113-7"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1556860"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.19.01442"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.55786"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.22.01096"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2017.01.012"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.11005\/jbm.2020.27.4.261"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2021.02.002"},{"key":"e_1_3_2_16_2","unstructured":"R Core Team. 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