Interpretation of Post-operative Distal Humerus Radiographs After Internal Fixation: Prediction of Later Loss of Fixation

Autor: Femke M.A.P. Claessen, Nicky Stoop, Job N. Doornberg, Thierry G. Guitton, Michel P.J. van den Bekerom, David Ring, A.B. Spoor, A. Chauhan, A.L. Wahegaonkar, A.B. Shafritz, A.E. Garcia G, A.N. Miller, A. Barquet, A. Kristan, T. Apard, A.D. Armstrong, A. Berner, A. Jubel, B.E. Kreis, C.G. Babis, B. Sutker, B.W. Sears, B.M. Nolan, B.D. Crist, B.J. Cross, B.P. Wills, C.J. Barreto, C. Ekholm, C. Swigart, C.D. Oliveira Miranda, C. Manke, C. Zalavras, C.A. Goldfarb, C. Cassidy, C.J. Walsh, C.M. Jones, C. Garnavos, C. Young, C.L. Moreno-Serrano, C. Lomita, C. Klostermann, D.F. van Deurzen, D.A. Rikli, D. Polatsch, D. Beingessner, D. Drosdowech, D. Eygendaal, M. Patel, D. Brilej, E.T. Walbeehm, E.G. Ballas, E.F. Ibrahim, E. Melamed, E. Stojkovska Pemovska, E. Hofmeister, E.M. Hammerberg, F.T. Kaplan, F. Suarez, C.H. Fernandes, F. Lopez-Gonzalez, F.L. Walter, F. Frihagen, G.A. Kraan, G. Kontakis, G.S. Dyer, G. Kohut, G. Panagopoulos, G.R. Hernandez, G. Porcellini, G.J. Bayne, G. Merrell, G. DeSilva, G.J. Della Rocca, H.B. Bamberger, H. Broekhuyse, H. Durchholz, I.F. Kodde, I. McGraw, I. Harris, I. Pountos, J.M. Wiater, J. Choueka, J.E. Kazanjian, J.A. Gillespie, J. Biert, J.C. Fanuele, J.W. Johnson, J.A. Greenberg, J. Abrams, J. Hall, J. Fischer, J.H. Scheer, J. Itamura, J.T. Capo, J. Braman, J. Rubio, J.A. Ortiz, J.E. Filho, J. Nolla, J. Abboud, J.M. Conflitti, J.M. Abzug, J.M. Patiño, J.M. Rodríguez Roiz, J. Adams, J. Bishop, K. Kabir, K. Chivers, K. Prommersberger, K. Egol, K.M. Rumball, K. Dickson, K. Jeray, L.M. Poelhekke, L.A. Campinhos, L. Mica, L.C. Borris, L.E. Adolfsson, L.M. Schulte, L. Elmans, L.B. Lane, L. Paz, L. Taitsman, L. Guenter, L.S. Austin, M. Waseem, M.J. Palmer, M.I. Abdel-Ghany, M.J. Richard, M. Rizzo, M. Pirpiris, M. Di Micoli, M. Bonczar, M.I. Loebenberg, M. Richardson, M. Mormino, M. Menon, M. Soong, M.M. Wood, S.A. Meylaerts, M. Darowish, M. Nancollas, M. Prayson, M.W. Grafe, M.W. Kessler, M.D. Kaminaris, M.A. Pirela-Cruz, M. Mckee, M. Merchant, M. Tyllianakis, M. Shafi, A.J. Powell, N.L. Shortt, N.E. Felipe, N. Parnes, N. Bijlani, N. Elias, N.M. Akabudike, N. Rossiter, N.G. Lasanianos, N.K. Kanakaris, O. Brink, P.V. van Eerten, P. Paladini, P.A. Martineau, P. Appleton, P. Levin, P. Althausen, P.J. Evans, P. Jebson, P. Krause, P. Schandelmaier, A. Peters, P. Dantuluri, P. Blazar, P. Andreas, P. Inna, M. Quell, R.M. Ramli, R. de Bedout, A.B. Ranade, S. Ashish, R.M. Smith, R.H. Babst, R. Omid, R. Buckley, R. Jenkinson, R.S. Gilbert, R.S. Page, R. Papandrea, R.D. Zura, R.L Gray, R. Wagenmakers, R. Pesantez, R. van Riet, R.P. Calfee, S.H. van Helden, S. Bouaicha, S. Kakar, S. Kaplan, F.D. Scott, S.G. Kaar, S. Mitchell, S. Rowinski, S. Dodds, S.A. Kennedy, S. Beldner, T. Schepers, T.G. Guitton, T. Gosens, T. Baxamusa, C. Taleb, T. Tosounidis, T. Wyrick, T. Begue, T. DeCoster, T. Dienstknecht, T.F. Varecka, T. Mittlmeier, T.J. Fischer, T. Chesser, T. Omara, T. Bafus, T. Siff, T. Havlicek, V.J. Sabesan, V.S. Nikolaou, V. Philippe, V. Giordano, A.J. Vochteloo, W.A. Batson, W.C. Hammert, W. Satora, Y. Weil, D. Ruch, L. Marsh, M. Swiontkowski, S. Hurwit
Přispěvatelé: Orthopedic Surgery and Sports Medicine, Other departments, Graduate School, Other Research, Surgery
Rok vydání: 2016
Předmět:
Male
Time Factors
Radiography
medicine.medical_treatment
elbow trauma
Cohort Studies
Fracture Fixation
Internal

Injury Severity Score
Postoperative Complications
0302 clinical medicine
Fracture Fixation
Elbow Joint
Fracture fixation
Orthopedics and Sports Medicine
Postoperative Period
Range of Motion
Articular

Fracture Healing
Observer Variation
030222 orthopedics
musculoskeletal system
Interobserver study
Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10]
Treatment Outcome
Predictive value of tests
Female
Range of motion
Adult
Range of Motion
Reoperation
musculoskeletal diseases
Humeral Fractures
medicine.medical_specialty
Bone healing
Risk Assessment
03 medical and health sciences
Fixation (surgical)
Predictive Value of Tests
medicine
distal humerus fracture
Humans
Internal fixation
Retrospective Studies
business.industry
030208 emergency & critical care medicine
Follow-Up Studies
Internal
Surgery
Orthopedic surgery
Elbow Injuries
business
Articular
Zdroj: The Journal of Hand Surgery, 41, e337-e341
Journal of hand surgery, 41(10), E337-E341. W.B. Saunders Ltd
The Journal of Hand Surgery, 41, 10, pp. e337-e341
ISSN: 0363-5023
Popis: Item does not contain fulltext PURPOSE: Stable fixation of distal humerus fracture fragments is necessary for adequate healing and maintenance of reduction. The purpose of this study was to measure the reliability and accuracy of interpretation of postoperative radiographs to predict which implants will loosen or break after operative treatment of bicolumnar distal humerus fractures. We also addressed agreement among surgeons regarding which fracture fixation will loosen or break and the influence of years in independent practice, location of practice, and so forth. METHODS: A total of 232 orthopedic residents and surgeons from around the world evaluated 24 anteroposterior and lateral radiographs of distal humerus fractures on a Web-based platform to predict which implants would loosen or break. Agreement among observers was measured using the multi-rater kappa measure. RESULTS: The sensitivity of prediction of failure of fixation of distal humerus fracture on radiographs was 63%, specificity was 53%, positive predictive value was 36%, the negative predictive value was 78%, and accuracy was 56%. There was fair interobserver agreement (kappa = 0.27) regarding predictions of failure of fixation of distal humerus fracture on radiographs. Interobserver variability did not change when assessed for the various subgroups. CONCLUSIONS: When experienced and skilled surgeons perform fixation of type C distal humerus fracture, the immediate postoperative radiograph is not predictive of fixation failure. Reoperation based on the probability of failure might not be advisable. TYPE OF STUDY/LEVEL OF EVIDENCE: Diagnostic III.
Databáze: OpenAIRE