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Although plates are the most stable means of fixation of midshaft metacarpal fractures, if minimally-invasive techniques are indicated, intramedullary nails may provide equivalent stability as commonly-used XK-wires. Although some studies have shown favorable clinical outcomes with IMNs, additional clinical correlation of these biomechanical results to fracture healing and outcomes is needed.

The authors explain why physicians should refrain from ordering MRIs for patients with renal dysfunction unless the test is essential to provide diagnostic information. A possibly class-wide toxicity from the contrast agent gadolinium has been reported.

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Background: The supine straight-leg raise (SLR) test has the potential to be exploited by malingering patients. The sitting SLR is believed to be less recognizable, therefore decreasing the chance of fabrication. The authors aim to compare the supine and sitting SLR test in patients with radiculopathy.Methods: A total of 107 patients with radiculopathy were included in this study. Two groups were created: patients with workman's compensation (Group 1) and a control group of patients without litigation claims (Group 2).Results: Mean age was 47.3 6 1.3 years with a 51% female population. Correlation analysis demonstrated association between mean angles in both positions, r ¼ 0.248 with significance P ¼ .01. There was equivalence in the mean angles in sitting position of 37 6 38 compared to 35 6 28 in supine position (P ¼ .549). There was no significant difference in the mean angle at which the test became positive in the litigation group in the sitting or supine position compared to the nonlitigation group, P ¼ .616 and P ¼ .49 respectively.Conclusion: This study demonstrated that the SLR test is equivalent in the sitting and supine position. Therefore, patients with a positive test should have similar angles in both positions, decreasing the chance of falsifying the examination.Level of Evidence: Prospective analysis. Clinical Relevance: Clinical practice.