期刊
JOURNAL OF ORTHOPAEDIC RESEARCH
卷 26, 期 8, 页码 1046-1052出版社
JOHN WILEY & SONS INC
DOI: 10.1002/jor.20550
关键词
fracture severity; intra-articular; post-traumatic arthritis
类别
资金
- NIAMS NIH HHS [R24 AR046601, P50 AR055533, P50 AR048939-01, R01 AR046601, R24 AR046601-01, AR46601, P50 AR055533-019001, P50 AR048939-010001, AR48939, P50 AR048939, P50 AR055533-01, AR55533, P50 AR048939-019002] Funding Source: Medline
The energy of producing a fracture is considered one of the most important factors relating to injury severity, prognosis, and risk of complications, yet there has been no objective way to measure this important variable. The purpose of this study was to compare assessments of fracture severity made using new objective computed tomography (CT)-based methods versus the expert opinion of experienced orthopedic traumatologists. Fracture energy, fragment displacement, and soft tissue swelling were quantified in twenty tibial plafond fractures by analyzing injury CT scans. Three experienced orthopedic traumatologists then independently performed a rank order analysis of fracture severity, using plain radiographs. The concordance among the three clinicians ranged from 87% to 91%. Objective fracture severity measurements made with the CT algorithm agreed well with the clinical assessments (fracture energy concordance from 73% to 76%, fragment displacement from 82% to 89%, and soft tissue swelling from 61% to 65%). These are the first objective, CT-based measures of fracture severity. With further refinement, this conceptually novel method has the potential to serve as a valuable tool to provide objective measurement of fracture severity, allowing one to control for this previously confounding variable in large multicenter studies. (c) 2008 Orthopaedic Research Society.
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