Abstract:
OBJECTIVE:To identify the fracture characteristics that can be reliably assessed by analysis of plain radiographs of tibial plateau fractures. DESIGN:Radiographic review study. PARTICIPANTS:Five orthopaedic traumatologists served as observers. INTERVENTION:Observers made assessments based on the radiographs of fifty-six tibial plateau fractures. Precise definitions of the assessments to be made were agreed on by all observers. The tested assessments included raters' abilities to identify and locate fracture lines, identify the presence of fracture displacement and comminution, make quantitative measurements of displacement, and characterize qualitative features of fractures. For thirty-eight of the fractures that had a computed tomography (CT) scan available, assessments were repeated using both radiographs and CT scans. MAIN OUTCOME MEASURES:To characterize interobserver reliability, percentage agreement and kappa statistics were calculated for categorical variables, and intraclass correlation coefficients (ICC) were calculated for noncategorical variables. RESULTS:Reliability of the assessments varied widely. Determining the location of fracture lines had the greatest reliability, whereas the subjective assessments of fracture stability and energy showed the poorest reliability. Although the ICCs for quantitative measurements approached acceptable levels, the tolerance limits were extremely wide. The addition of a CT scan improved the reliability of most assessments, but not to a statistically significant degree. CONCLUSIONS:Many basic radiographic interpretations relied on in making treatment decisions are made variably by observers. Using experienced raters and precise definitions of fracture assessments does not guarantee a high level of agreement. Discrete assessments have higher interrater agreements than do more qualitative assessments. Quantitative measures have wide tolerance limits and, therefore, probably cannot be used reproducibly to classify fractures or make treatment decisions. We conclude the reliability of fracture classification is limited by raters' abilities to agree on basic radiographic assessments.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Martin J,Marsh JL,Nepola JV,Dirschl DR,Hurwitz S,DeCoster TAdoi
10.1097/00005131-200008000-00001subject
Has Abstractpub_date
2000-08-01 00:00:00pages
379-85issue
6eissn
0890-5339issn
1531-2291journal_volume
14pub_type
杂志文章abstract:OBJECTIVE:This study was conducted to categorize barefoot stubbing injuries to the great toe in children by injury mechanism to differentiate benign stubbing injuries from more complex injuries necessitating surgery. DESIGN:Prospective clinical series of consecutively treated patients. SETTING:Tertiary university hos...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31828e5d39
更新日期:2013-11-01 00:00:00
abstract::Young surgeons and their spouses experience a myriad of stresses in the first few years of practice. Issues related to job search, moving to a new community, learning one's craft, time management, changes to spouse's career, child rearing, and the ever blurring line between work time and free time may all contribute t...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3182641fd8
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:Low-intensity pulsed ultrasound (LIPUS) provides noninvasive therapeutic treatment to accelerate fracture repair and distraction osteogenesis. However, most studies concerning the influence of LIPUS on bone metabolism have been conducted in vivo systems using osteoblastic cells. Therefore, details of the dire...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000489982.40329.52
更新日期:2016-08-01 00:00:00
abstract::Results of hemiarthroplasty for complex four-part proximal humerus fractures in the elderly have been unreliable. Although patients often achieve pain relief, return of above-shoulder level function can be challenging, because tuberosity nonunion, malunion, and/or resorption is quite common. The reverse shoulder repla...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181f22088
更新日期:2011-05-01 00:00:00
abstract::Business intelligence in the field of medicine, particularly with physicians, has been an abstract concept at best with no objective metric. Furthermore, in many arenas, it was taboo for medical students, residents, and physicians to discuss the business and finances of their work for fear that it would interfere with...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000177
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to evaluate the loss of strength in the distal humerus that resulted from the creation of two different entry portals used for retrograde humeral nailing. DESIGN:Nine pairs, treated as blocks of size two, of fresh frozen humeri from individuals free of musculoskeletal disease w...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200002000-00005
更新日期:2000-02-01 00:00:00
abstract:OBJECTIVE:New locked plate devices offer theoretical advantages for the treatment of supracondylar femur fractures associated with a total knee arthroplasty (TKA). These devices also can be inserted with relative ease by using minimally invasive techniques, provide a fixed angle construct, and improve fixation in osteo...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200603000-00005
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVE:To determine the impact of smoking on intensive care unit (ICU) outcomes in patients who underwent operative fixation for spine trauma. DESIGN:Retrospective cohort study. SETTING:Single academic level I trauma center. PATIENTS:One hundred eighty-one consecutive surgical spine trauma patients from January 2...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001739
更新日期:2020-07-01 00:00:00
abstract::Severe crush injuries to the midfoot often involve comminuted cuneiform or tarsal navicular fractures. Treatment principles for the bony injury of the crushed midfoot include maintenance of the medial column length and alignment, as well as appropriate stable fixation after open or closed fracture reductions. This is ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/00005131-200308000-00007
更新日期:2003-08-01 00:00:00
abstract::Aggressive treatment of the multiply injured patient often requires early fixation of many fractures, some of which may be open. Often, patients develop postoperative fevers requiring a thorough workup to rule out infection. Recently, indium-111 white blood cell (WBC) imaging has become a valuable adjunct in the diagn...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVE:The aims of this study were to analyze a large national trauma database to determine the incidence of, risk factors for, and outcomes after a fasciotomy of the lower leg or forearm after fracture. METHODS:Data from the National Trauma Data Bank for the years 2004-2016 were analyzed, and we identified 301,351...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001702
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVE:To determine the prognostic reliability, sensitivity, and specificity of the Hawkins sign. The Hawkins sign is a subchondral radiolucent band in the talar dome that is indicative of viability at 6 to 8 weeks after a talus fracture. It is visible in the anterior-posterior view, but seldom appears on lateral ra...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318148c665
更新日期:2007-09-01 00:00:00
abstract:OBJECTIVES:To evaluate use of intraoperative fluoroscopy during acetabular surgery to determine fracture reduction and accurate placement of screws. DESIGN:Retrospective. SETTING:Level I trauma center. PARTICIPANTS:Thirty patients with thirty-two acetabular fractures. INTERVENTION:Patients were evaluated with fluor...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199908000-00004
更新日期:1999-08-01 00:00:00
abstract:OBJECTIVES:External fixator pins are thought to have improved pullout strength if inserted into both cortices and if pilot holes are drilled. We tested these hypotheses and investigated effects of osteoporosis and pin location on pin pullout strength. METHODS:Self-drilling external fixator pins were inserted using 4 t...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3182511ed7
更新日期:2013-02-01 00:00:00
abstract::In a 3-year prospective randomized trial, the prognostic value of osteoporosis in terms of predicting healing complications due to implant failures or loss of fracture reduction has been studied in 113 patients with inter-trochanteric hip fractures treated with either a sliding screwplate or Ender nailing. According t...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00005131-199310000-00006
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVES:With value-based payment models on the horizon, this study was designed to examine the perceptions of value-based care among orthopaedic traumatologists and how they influence their practice. DESIGN:Systems-based survey study. SETTING:Orthopaedic Trauma Association (OTA) research surveys. PARTICIPANTS:OTA...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001622
更新日期:2019-11-01 00:00:00
abstract::We report an isolated anterior dislocation of the radial head in an adult after sustaining a fall on the outstretched arm. Based on history and presentation, we speculate that the injury occurred in a position of hyperextension and supination. Reduction was achieved by a pronation maneuver. ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199505000-00014
更新日期:1995-01-01 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:OBJECTIVE:To evaluate the functional outcomes and pain in patients with unilateral posterior pelvic ring injuries treated with transiliac-transsacral screw fixation compared with unilateral iliosacral screw fixation. DESIGN:Retrospective comparative study. SETTING:Three academic level 1 trauma centers. PATIENTS/PART...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,多中心研究
doi:10.1097/BOT.0000000000000622
更新日期:2016-09-01 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:OBJECTIVE:To characterize the presentation and outcomes of calcaneal avulsion fractures. DESIGN:Case series. SETTING:Two ACS Level I trauma centers. PATIENTS/PARTICIPANTS:Forty-seven calcaneal avulsion fractures isolated from a cohort of 1365 calcaneus fractures treated over a 17-year period. MAIN OUTCOME MEASUREME...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,多中心研究
doi:10.1097/BOT.0000000000001582
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE:Risk for bleeding complications during and after early hip fracture surgery for patients taking clopidogrel and other anticoagulants have not been defined. The purpose of this study is to assess the perioperative bleeding risks and clinical outcome after early hip fracture surgery performed on patients taking...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318240d70f
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVES:A sheep model of osteoporosis suitable for implant testing for osteoporotic fractures was evaluated with regard to normalization of hormonal status and possible rebound of bone mineral density subsequent to the termination of steroid application. DESIGN:Osteoporosis was induced in 10 aged, female white alpi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200501000-00005
更新日期:2005-01-01 00:00:00
abstract:PURPOSE:Comminuted iliac fractures are uncommon and difficult to treat. The purpose of this study is to further delineate the fractures, to present a management protocol, and to evaluate the results of treatment. DESIGN:Retrospective clinical study. SETTING:Level one trauma center at Harborview Medical Center. PATIE...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200005000-00008
更新日期:2000-05-01 00:00:00
abstract:SUMMARY:In this study, we present a novel technique for reduction and fixation of complex, unstable proximal humerus fractures with diaphyseal extension with the assistance of fibula allograft. We treated 14 patients using this technique since 2009 and found that it improves the reduction and enhances fixation while ma...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31829a346d
更新日期:2014-03-01 00:00:00
abstract::The distribution of clindamycin in tibial cortical bone, administered via direct local infusion with an implantable pump, is described. Clindamycin concentrations in cortical bone were measured after 3, 7, and 21 days of intraosseous infusion. The tibia were divided into four quadrants relative to the outflow infusion...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199410000-00003
更新日期:1994-10-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to analyze the appropriateness of transfer of patients with orthopaedic injuries to a Level I trauma center from surrounding Level II to IV centers. DESIGN:A prospective study was conducted over a 5-month period by collecting data on all orthopaedic patients being transferred ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181b18b89
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVES:To assess the recovery of ankle function and general health status at multiple time points during the first 24 months after an isolated tibial plafond fracture treated with joint-spanning external fixation and to determine factors that affect a rapid versus a slow recovery and factors that influence patient ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181c8ad52
更新日期:2010-08-01 00:00:00
abstract::Nail plate combination technique can be applied in the setting of periprosthetic and interprosthetic fractures to promote reliable healing with a biomechanically favorable construct. Here, technical aspects and discussion of the technique are reviewed through a case of an 87-year-old woman who suffered from an interpr...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001571
更新日期:2019-09-01 00:00:00
abstract:OBJECTIVE:To evaluate the cost-effectiveness of screw fixation versus hemiarthroplasty for nondisplaced femoral neck fractures in low-demand elderly patients. METHODS:We constructed a Markov decision model using a low-demand, 80-year-old patient as the base case. Costs, health-state utilities, mortality rates, and tra...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001747
更新日期:2020-07-01 00:00:00