Radiographic characterization of acute scaphoid fractures in children under 11 years of age
Autor: | Summer L. Kaplan, Andressa Guariento, Alexandre Arkader, Zonia R. Moore, Jie C. Nguyen, Shijie Hong, Michael K Nguyen |
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Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
business.industry Ossification Radiography Wrist Delayed diagnosis Institutional review board 030218 nuclear medicine & medical imaging 03 medical and health sciences symbols.namesake 0302 clinical medicine medicine.anatomical_structure Pediatrics Perinatology and Child Health Orthopedic surgery medicine symbols Radiology Nuclear Medicine and imaging Radiology medicine.symptom business 030217 neurology & neurosurgery Fisher's exact test Neuroradiology |
Zdroj: | Pediatric Radiology. 51:1690-1695 |
ISSN: | 1432-1998 0301-0449 |
Popis: | Delayed diagnosis of scaphoid fractures can lead to long-term morbidity. While radiography is the preferred screening examination, there is a relative paucity of literature that examines fracture visibility in younger children, who have smaller ossification centers, an abundance of unossified cartilage and fractures that preferentially involve the distal scaphoid. To characterize acute scaphoid fractures in younger children on radiographs with observer agreement and with respect to fracture location. This institutional review board (IRB)-approved and Health Insurance Portability and Accountability Act (HIPAA)-compliant cross-sectional study included children (≤10 years of age) with acute scaphoid fractures (≤7 days), who underwent radiographic examinations at a tertiary children’s hospital between December 2008 and June 2019. Three readers (two pediatric radiologists and one orthopedic surgeon) reviewed each examination to determine fracture visibility on each radiographic view and fracture location. Kruskal-Wallis, Fisher exact and Cochran-Armitage tests were used to compare fracture visibility and location, and Kappa tests were used to calculate observer agreement. Twenty-eight children (15 boys, 13 girls; mean age: 9.5±0.6 years) with 10 (36%) distal corner, 11 (39%) distal body and 7 (25%) mid-body fractures, underwent 7 (25%) 4-view, 18 (64%) 3-view and 3 (11%) 2-view examinations. Twenty-six (93%) fractures were visible on at least one view with six (21%) fractures visible on all available views. No significant association was found between fracture visibility and fracture location (P=0.32). Observer agreement was substantial to almost perfect. Only 7% of these acute scaphoid fractures in younger children are inconspicuous on the initial radiographic examination. |
Databáze: | OpenAIRE |
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