Radiographic Union Scoring Scale for Determining Consolidation Rates in the Calcaneus.

Autor: Sganga ML; Chief Resident, Division of Podiatric Surgery, Department of Surgery, Mount Auburn Hospital, Cambridge, MA; Clinical Fellow, Department of Surgery, Harvard Medical School, Boston, MA., Summers NJ; Clinical Fellow, Department of Surgery, Harvard Medical School, Boston, MA; Fellow, Foot and Ankle Reconstruction, Coordinated Health, Bethlelem, PA., Barrett B; Chief Resident, Division of Podiatric Surgery, Department of Surgery, Mount Auburn Hospital, Cambridge, MA; Clinical Fellow, Department of Surgery, Harvard Medical School, Boston, MA., Matthews MR; Clinical Fellow, Department of Surgery, Harvard Medical School, Boston, MA., Karthas T; Clinical Fellow, Department of Surgery, Harvard Medical School, Boston, MA. Electronic address: tkarthas@mah.harvard.edu., Johnson L; Assistant Director of Resident Training, Division of Podiatric Surgery, Department of Surgery, Mount Auburn Hospital, Cambridge, MA., Cook JJ; Instructor, Department of Surgery, Harvard Medical School, Boston, MA; Director of Research and Quality Assurance, Division of Podiatric Surgery, Department of Surgery, Mount Auburn Hospital, Cambridge, MA., Basile P; Instructor, Department of Surgery, Harvard Medical School, Boston, MA; Chief, Division of Podiatric Surgery, Department of Surgery, Mount Auburn Hospital, Cambridge, MA., Cook EA; Instructor, Department of Surgery, Harvard Medical School, Boston, MA; Director of Resident Training, Division of Podiatric Surgery, Department of Surgery, Mount Auburn Hospital, Cambridge, MA.
Jazyk: angličtina
Zdroj: The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons [J Foot Ankle Surg] 2018 Jan - Feb; Vol. 57 (1), pp. 2-6. Date of Electronic Publication: 2017 Oct 13.
DOI: 10.1053/j.jfas.2017.05.035
Abstrakt: The reliable evaluation of osseous consolidation after hindfoot osteotomy can be difficult. Concomitant hindfoot osteotomies often dictate the advancement of weightbearing, and radiographs are the mainstay imaging tool owing to cost, efficiency, and radiation exposure. Understanding the radiographic parameters that can be used to reliably determine osseous healing is paramount. However, currently, no reliable or validated method is available to determine osseous healing of hindfoot osteotomies in irregular bones of the foot. The purpose of the present study was to develop a radiographic healing scoring system that would enhance the diagnostic healing assessment after elective calcaneal osteotomy. We adapted existing orthopedic scales validated for healing in the leg for application in the irregular bones of the foot. A total of 168 cases were evaluated by 6 blinded assessors to test the interrater reliability of subjective healing assessment compared with the proposed scoring system. The radiographs were classified by postoperative period: ≤4 weeks, 5 to 12 weeks, and >12 weeks. The proposed scale had high interrater reliability but was burdensome. Using a priori item reduction protocols, a limited 6-item scale further improved internal consistency and reduced the burden. The result was excellent interrater reliability (α = 0.98, standard deviation 0.02, 95% confidence interval 0.91 to 0.96) among all assessors when using the scoring scale compared with unacceptable reliability (α = 0.438) for subjective osteotomy healing. The reliability of our system appeared superior to that of subjective assessment of osseous healing alone, even in the absence of clinical correlates after osteotomy of the calcaneus.
(Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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