Nonossifying Fibromas: A Computed Tomography–based Criteria to Predict Fracture Risk
| Autor: | Scott J. Mubarak, Amanda N Goldin, David A. Muzykewicz |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
Fracture risk Adolescent Bone Neoplasms Computed tomography Fibroma Risk Assessment Sensitivity and Specificity 03 medical and health sciences Distal femur 0302 clinical medicine medicine Humans Orthopedics and Sports Medicine Child Retrospective Studies 030222 orthopedics medicine.diagnostic_test business.industry Retrospective cohort study General Medicine Distal tibia medicine.disease Sagittal plane Tibial Fractures Fractures Spontaneous medicine.anatomical_structure Coronal plane Pediatrics Perinatology and Child Health Female Tomography X-Ray Computed Nuclear medicine business Femoral Fractures |
| Zdroj: | Journal of Pediatric Orthopaedics. 40:e149-e154 |
| ISSN: | 0271-6798 |
| DOI: | 10.1097/bpo.0000000000001408 |
| Popis: | Author(s): Goldin, Amanda N; Muzykewicz, David A; Mubarak, Scott J | Abstract: BackgroundNonossifying fibroma (NOF) is the most common benign osseous lesion in children; however, our understanding of which lesions progress to a fracture remains unclear. In this study, we seek to formulate a classification system for NOFs to assess for fracture risk and determine what this classification system tells us regarding fracture risk of the distal tibia and distal femur NOFs.MethodsCharts were retrospectively reviewed for patients with NOFs. A 4-point criteria was created and used to calculate fracture risk for distal tibia and distal femur NOFs. The analysis included incidence, specificity, and sensitivity.ResultsOne point was given for each of the following findings on computed tomography (CT) scan: (1) g50% width on coronal view; (2) g50% width on sagittal view; (3) any cortical breach; (4) lack of a neocortex. In total, 34 patients with NOFs of the distal tibia had CT scans, of which 14 fractured. Zero with a 0- or 1-point score fractured, 2 with a 2-point score fractured (20%), 4 with a 3-point score fractured (44%), and 8 with a 4-point score fractured (100%). Sensitivities of 1-, 2-, 3-, and 4-point scores were 100%, 100%, 85.7%, and 57.1%, respectively, and specificities were 71.4%, 71.4%, 80%, and 100%, respectively. A total of 41 patients with NOFs of the distal femur had CT scans, of which 5 fractured. Zero with a 0-point score fractured, 1 with a 1-point score fractured (4%), 0 with a 2-point score fractured, 1 with a 3-point score fractured (20%), and 3 with a 4-point score fractured (100%). Sensitivities of 1-, 2-, 3-, and 4-point scores were 100%, 80%, 80%, and 60%, respectively; and specificities were 60%, 87.8%, 90%, and 100%, respectively.ConclusionsOur 4-point CT criteria is easy to apply and identifies patients at high risk of fracture, helping surgeons make decisions regarding treatment.Level of evidenceLevel IV-prognostic study. |
| Databáze: | OpenAIRE |
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