Case Report: Bilateral congenital fourth metacarpal shortening in a competitive softball athlete with preserved function - Summary - MDSpire

Case Report: Bilateral congenital fourth metacarpal shortening in a competitive softball athlete with preserved function

  • By

  • Sui-Ling Perez

  • Rakesh R. Nair

  • Noah S. Llaneras

  • Emily Garateix

  • Lidia Sabater

  • Roberto A. Miki

  • July 8, 2026

  • 0 min

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Objective:

To assess the functional outcomes of bilateral congenital shortening of the fourth metacarpal in a competitive athlete.

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Key Findings:
  • The patient had stable morphology of the fourth metacarpals over more than a decade.
  • She maintained a full, pain-free range of motion in both hands after conservative management.
  • No history of hand dysfunction was reported, even with high-level athletic participation.
Interpretation:

This case suggests that bilateral congenital shortening of the fourth metacarpal can be compatible with high-level athletic participation without functional limitations.

Limitations:
  • Formal grip dynamometry and validated functional scores were not utilized.
  • The study is based on a single case report, limiting generalizability.
Conclusion:

Conservative management with reassurance is appropriate for asymptomatic patients, and recognition of this condition can prevent misinterpretation as trauma-related shortening.

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