Coronal displacement in proximal humeral fractures: correlation between shoulder radiographic and computed tomography scan measurements
| Autor: | Aleksandar Munjin, Nelson A. Fritis, Patricio Melean, José Tomás Rojas, Alfonso Pérez, Erik R. Cook |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Radiography Concordance Computed tomography Correlation 03 medical and health sciences 0302 clinical medicine medicine Humans Orthopedics and Sports Medicine Displacement (orthopedic surgery) Body Weights and Measures Arthrography Aged Retrospective Studies Observer Variation 030222 orthopedics Calcar medicine.diagnostic_test business.industry Reproducibility of Results 030229 sport sciences General Medicine Middle Aged Coronal plane Correlation analysis Shoulder Fractures Surgery Female Radiology business Nuclear medicine Tomography X-Ray Computed |
| Zdroj: | Journal of shoulder and elbow surgery. 26(1) |
| ISSN: | 1532-6500 |
| Popis: | The purpose of this study was to analyze if there is a correlation in displacement measurements in coronal projections between shoulder radiographs and computed tomography (CT) scans in patients with proximal humeral fractures (PHFs).A comparative, retrospective analysis of images from our database was performed. Ninety-seven cases with PHFs with radiographs and CT scans were included. Four evaluators measured PHF displacement using the following: metaphyseal extension (ME), medial calcar (MC) medialization, apex-tuberosity distance (ATD), and cervicodiaphyseal (CD) angle. Measurement reliability was evaluated with a pilot sample by performing intraclass coefficient correlation analysis. Surgery indication according to displacement (CD angle105° or155° and ATD3 mm) and agreement analysis were assessed by κ tests.All evaluated parameters presented correlations among methods for intrarater and inter-rater reliability. All measurements showed significant differences (ME of 1.2 ± 6 mm, P = .034; MC of 1 ± 5 mm, P = .041; ATD of 2.6 ± 5 mm, P = .001; and CD angle of 9° ± 16°, P = .001). Regarding indications for treatment type relating to ATD and CD angle, there was agreement between CT scans and radiographs in 66 of 97 cases (κ = 0.351, P .001). Twelve cases with surgical indications by CT scans had conservative indications by radiographs, whereas in 19 cases with conservative indications by CT scans, radiographic measurements suggested surgical treatment.This study documented regular concordance between radiographs and CT scans for coronal displacement measurements in PHFs. Statistical differences were documented for all measurements. Webelieve that ATD and CD angle differences are clinically relevant (mean, 3 mm and 9°, respectively) because these differences might change the type of treatment. |
| Databáze: | OpenAIRE |
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