Abstract:
OBJECTIVE:To determine whether the superior sensitivity of computed tomography (CT) results in changes in treatment plans for cervical spine fractures that have been diagnosed on plain films alone. DESIGN:Retrospective review of radiographic studies for cervical spine trauma. SETTING/PARTICIPANTS:An orthopaedic spine surgeon (SS), an orthopaedic traumatologist (OT), an orthopaedic spine fellow (SF), and an orthopaedic chief resident (CR) were independently presented thirty-nine cases of cervical spine trauma imaged with adequate plain radiographs and with CT. MAIN OUTCOME MEASURES:Agreement was measured by calculation of kappa coefficients. RESULTS:The detection rate of total fractures on plain radiographs alone ranged from 47 percent to 71 percent, and the diagnosis changed an average 53 percent of cases. Change in treatment plans ranged from 10 percent (SS) to 46 percent (CR) of cases. Of these changes, undertreatment occurred as follows: SS =3 percent, OT =8 percent, SF =36 percent, and CR = 46 percent. The mean kappa coefficient for intraobserver agreement of treatment plans was 0.69. The experienced observers demonstrated "excellent" agreement with an average kappa coefficient of 0.85, whereas the mean coefficient for inexperienced observers was 0.54 or "moderate" agreement. Complete diagnostic agreement occurred between the experienced observers after review of both the plain films and CT scans. The interobserver agreement of treatment plans for the experienced observers increased from 0.79 to 0.88. CONCLUSIONS:CT scanning afforded additional information for all observers. Experienced observers can reliably determine treatment plans for cervical spine trauma diagnosed on plain films alone, whereas inexperienced observers are less reliable. For the experienced observers, interobserver agreement on treatment plans increased after the addition of CT.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Katz MA,Beredjiklian PK,Vresilovic EJ,Tahernia AD,Gabriel JP,Chan PS,Heppenstall RBdoi
10.1097/00005131-199906000-00003subject
Has Abstractpub_date
1999-06-01 00:00:00pages
338-43issue
5eissn
0890-5339issn
1531-2291journal_volume
13pub_type
杂志文章abstract::Immediate (within 24 h) open reduction and internal fixation of 103 open fractures of one or both bones of the forearm was accomplished in 69 patients between 1980 and 1989. Fifty-four of the 103 patients were reevaluated 1 to 7 years postinjury (average 2.5 years) to determine the efficacy of this treatment. Forty-fi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:
更新日期:1992-01-01 00:00:00
abstract::Prospectively, 40 patients with an average age of 45 (20-65) with closed transverse fractures of the middle one-third of the humerus without associated radial nerve palsy were treated. All had failed nonoperative reduction and were then operated on with either compression plating or intramedullary fixation with Hacket...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00005131-199506000-00003
更新日期:1995-06-01 00:00:00
abstract::We reviewed the treatment and results of 22 Bennett's fractures. Of these fractures, treated by closed reduction and plaster immobilization, 20 were available for follow-up. Eighteen patients had a subjectively satisfactory outcome, and seven had a radiographically confirmed arthrosis of the first carpometacarpal join...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199502000-00004
更新日期:1995-02-01 00:00:00
abstract:OBJECTIVES:To quantify the obliquity and dimensions of the upper and second sacral segment iliosacral screw safe zones and to determine the differences between normal and dysmorphic sacral morphology. DESIGN:Retrospective cohort. SETTING:University Level I trauma center. PATIENTS/PARTICIPANTS:Fifty patients with pel...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181cf0404
更新日期:2010-10-01 00:00:00
abstract::This report presents a case demonstrating the nonunion of a capital femoral physeal fracture with a large metaphyseal fragment in a 10-year-old boy. To our knowledge, there is no previously reported case of this type of nonunion. The treatment of this nonunion presented a potential risk of premature physeal closure an...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181c83a3b
更新日期:2010-08-01 00:00:00
abstract::Femoral shaft fractures are commonly treated with closed reduction and reamed intramedullary nailing. However, some reductions are difficult to obtain or maintain, especially in muscular or large patients. When closed methods fail to achieve reduction, percutaneous techniques are extremely useful. In addition, the use...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000890
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that oblique screws at the ends of a plate provide increased strength of fixation as compared to standard screw insertion. DESIGN:Biomechanical laboratory study in synthetic bone test medium. METHODS:Narrow 4.5-mm stainless steel low-contoured dynamic compression plates were anchored ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200410000-00006
更新日期:2004-10-01 00:00:00
abstract:OBJECTIVES:Long bone fractures that fail to heal or show a delay in healing can lead to increased morbidity. Bone marrow aspirate concentrate (BMAC) containing bone mesenchymal stem cells (BMSCs) has been suggested as an autologous biologic adjunct to aid long bone healing. The purpose of this study was to systematical...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000000453
更新日期:2016-01-01 00:00:00
abstract::Salvage of limb length following oblique proximal foot amputations is presented. The technique, results, and follow-up of this procedure are described and compared with other standard procedures. A prospective study was done on 3 adolescents who presented consecutively during years 1999 and 2000. The salvage procedure...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000164168.94365.49
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:Traumatic spondylolisthesis of the axis, is a common cervical spine fracture; however, to date there is limited data available to guide the treatment of these injuries. The purpose of this review is to provide an evidence-based analysis of the literature and clinical outcomes associated with the surgical and...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000000952
更新日期:2017-09-01 00:00:00
abstract::Although opioids are widely used for the management of pain in patients with hip fracture, these medications are known to have a wide range of adverse effects that can result in suboptimal outcomes or serious life-threatening complications. Common opioid-related adverse events include gastrointestinal effects, central...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000000563
更新日期:2016-05-01 00:00:00
abstract:OBJECTIVES:To compare the static and dynamic mechanical properties of a modified crossed cannulated screw (CS) configuration, the inverted triangle (IT) cannulated screw configuration, and a compression hip screw (CHS) with derotation screw in Pauwels type III femoral neck fractures. METHODS:Thirty synthetic femora we...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000836
更新日期:2017-07-01 00:00:00
abstract:SUMMARY:Convergent type radioulnar translocation is an extremely rare form of injury occurring in a growing child. We report a case of convergent radioulnar translocation along with a radial head fracture in a young child. Open reduction of the elbow and internal fixation of the radial head fragment helped in achieving...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0b013e31821d7fd5
更新日期:2012-04-01 00:00:00
abstract::Osteochondromas are one of the most commonly observed benign bone tumors. Although there have been a number of experimental studies carried out to determine the origin of osteochondromas, their etiology remains a controversial issue. A well-documented case is presented in which a displaced Salter-Harris type II physea...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199410000-00013
更新日期:1994-10-01 00:00:00
abstract:OBJECTIVE:To observe and report the clinical results of indirect plating techniques in the treatment of femoral shaft nonunions originally treated with intramedullary nailing. DESIGN:Prospective consecutive. SETTING:Regional trauma center. PATIENTS:A consecutive series of twenty-three patients with nonunion of femor...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200105000-00004
更新日期:2001-05-01 00:00:00
abstract::Although Kirschner wires are useful implants in many situations, migration of the wire and irritation of the surrounding soft tissues are common complications. Seven steps are described herein, which result in a Kirschner wire that is bent 180° angle, providing a smooth anchor into bone. Use of this technique produces...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318290f818
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVES:In the distal femur, locked plating is efficacious when coronal fractures preclude the use of a conventional fixed-angle device. However, minimal comparative data exist for supracondylar fracture patterns, which could be treated with other devices. The purpose of this study was to compare the 95-degree angle...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318234d460
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:The open reduction and internal fixation of radial shaft fractures and osteotomies with standard 3.5-mm plates can be complicated by tendon irritation, hardware prominence, and fracture through the screw holes. With the advent of locking plate technology, implant companies and some surgeons have recommended e...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181f8bf9b
更新日期:2011-06-01 00:00:00
abstract::Long-bone deformity may be significantly symptomatic. A uniplanar corrective osteotomy uses a single cut to correct coronal, sagittal, and axial plane deformity simultaneously. Careful preoperative planning is required in addition to a comprehensive understanding of the magnitude and plane of the true deformity of the...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001519
更新日期:2019-08-01 00:00:00
abstract::Healthcare policy has changed drastically, and with the 50-year anniversary of the passage of Medicare approaching in 2015, the authors evaluate the development of the current healthcare system and its relationship to the development of modern orthopaedic trauma. With more changes in healthcare policy forthcoming, it ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000214
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVES:The purposes of this study were to evaluate the cantilevered bending strength and failure modes of locking screws inserted at various angles in a plate with fully circumferential threaded holes. As an additional measure, the amount of screw head prominence at these angles was also assessed. METHODS:Standard...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000066
更新日期:2014-01-01 00:00:00
abstract::An 80-year-old man sustained a T-shaped supracondylar fracture of the femur associated with distal one-third shaft comminution. Initial failure of a 95 degrees angle blade plate was followed by insertion of an intraarticular intramedullary nail stabilized with static locking-screw fixation. A second failure of the imp...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199308000-00004
更新日期:1993-01-01 00:00:00
abstract::A study was undertaken to review the results of donor site morbidity of cancellous bone grafts obtained from the proximal tibial metaphysis. Two hundred six patients who underwent 230 proximal tibial bone graft harvestings were reviewed. Patients with lower-extremity fractures or nonunions who required cancellous bone...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199112000-00014
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVE:To determine whether an injectable thrombin product [thrombin hemostatic matrix (THM)] at closure of a Kocher-Langenbeck approach reduces the risk of heterotopic ossification (HO) formation after an acetabular fracture. DESIGN:Case control. SETTING:Two Level 1 trauma centers. PATIENTS:Patients with operati...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001783
更新日期:2020-09-01 00:00:00
abstract::A case is presented of scaphocapitate fracture syndrome associated with a Salter-Harris type II fracture of the distal radius and ulna occurring in an 11-year-old girl. The proximal fragment of the fractured capitate was rotated 180 degrees. The injury was treated by open reduction and internal fixation. One year afte...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199704000-00017
更新日期:1997-04-01 00:00:00
abstract:OBJECTIVES:To analyze long-term functional outcomes in patients with posttraumatic infected tibial nonunions having undergone bone transport with hexapod external fixator. DESIGN:Retrospective cohort study. SETTING:Level 1 trauma center. PATIENTS/PARTICIPANTS:Thirty-eight patients with infected nonunions of the tibi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001005
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVES:To highlight the potential for vascular injury with fracture of the distal radius. DESIGN:Retrospective case series. SETTING:The practices of several orthopaedic hand surgeons. PATIENTS/PARTICIPANTS:Six patients with arterial injury as a consequence of fracture of the distal radius: 2 partial lacerations ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318188d686
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVES:To investigate the incidence of concomitant posterior malleolar fractures (PMFs) in operative, distal-third, spiral tibia fractures. DESIGN:Prospective protocol with retrospective review of data. SETTING:Single, Level 1 trauma center. PATIENTS/PARTICIPANTS:One hundred ninety-three consecutive, skeletally ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001307
更新日期:2018-11-01 00:00:00
abstract::Over a 15-month period, 41 open grade I-IIIA tibia fractures were treated with unreamed interlocking nails. A protocol previously established by the authors to enhance fracture union was followed. The purpose of the study was to determine if union rate for the comminuted statically locked fracture could be reduced thr...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199504000-00005
更新日期:1995-04-01 00:00:00
abstract::The fracture classification systems currently used most frequently were not developed or validated by rigorous scientific evaluation methods. This paper discusses the classification of fractures from an epidemiological and clinical decision-making perspective and proposes a standardized methodological concept for thei...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/01.bot.0000155310.04886.37
更新日期:2005-07-01 00:00:00