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 their development and scientific validation. Classification categories are clinically relevant entities that surgeons should be able to use for diagnosis with sufficient confidence to limit misclassification and associated treatment errors. The process of validation should assess the value of specific clinical information (eg, the use of radiographs or computed tomography scans) in increasing the probability of a correct diagnosis. A 3-phase validation concept is proposed where: 1) classification categories are defined and the classification process using specific diagnostic images is evaluated by experts in a series of agreement studies (reliability, accuracy, likelihood ratios); 2) a multicenter agreement study is conducted among a representative group of future users of the classification; and 3) the classification proposal is applied in the context of a prospective clinical study to assess its clinical usefulness.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Audigé L,Bhandari M,Hanson B,Kellam Jdoi
10.1097/01.bot.0000155310.04886.37subject
Has Abstractpub_date
2005-07-01 00:00:00pages
401-6issue
6eissn
0890-5339issn
1531-2291pii
00005131-200507000-00008journal_volume
19pub_type
杂志文章,评审abstract:OBJECTIVE:Increasing evidence suggests long-term alendronate use may overly suppress bone metabolism, limiting repair of microdamage and creating risk for insufficiency fractures. The purpose of this study is to demonstrate an association between alendronate use and a specific pattern of low-energy femoral shaft fractu...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318172841c
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the results after closed reduction and percutaneous fixation of displaced fractures of the proximal humerus with the Humerusblock system. DESIGN:Prospective case series. SETTING:Level 1 trauma center. PATIENTS AND METHODS:Fifty-eight consecutive patients with displaced proximal humerus fracture...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181c81b1c
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVES:Evaluate the effect of the COVID-19 pandemic and the "shelter-in-place" order on orthopaedic trauma presenting to a community level II trauma center. It is hypothesized the overall number of orthopaedic trauma encounters (OTE), the number of OTEs related to both high and low severity injuries, as well as the...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001860
更新日期:2020-06-08 00:00:00
abstract::Traumatic spinal cord injuries have a tremendous impact on individuals, families, and society as a whole. Substantial heterogeneity in the patient population, their presentation and underlying pathophysiology has sparked debates along the care spectrum from initial assessment to definitive treatment. This article revi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000000943
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVES:To compare the accuracy of 5 commonly available fine wire tensioners used in hybrid and ring external fixation. DESIGN:A laboratory investigation. SETTING:The testing of 5 commonly available tensioners was performed with a servohydraulic test frame (MTS Bionix 858, Minneapolis, MN). MAIN OUTCOME MEASUREME...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200403000-00006
更新日期:2004-03-01 00:00:00
abstract::Fractures of the distal humerus involving the articular surface can be challenging. The complexity of these fracture patterns increases when the distal fracture is associated with a concomitant humeral shaft fracture with significant proximal extension. The combined exposure technique described here allows for consist...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000245988.23684.79
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVES:This study evaluated whether patients with a left-sided femoral neck fracture (FNF) treated with a sliding hip screw (SHS) had a higher implant failure rate than patients treated for a right-sided FNF. This was performed to determine the clinical relevance of the clockwise rotational torque of the femoral ne...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001934
更新日期:2020-11-01 00:00:00
abstract::The extraosseous tissue contribution to diaphyseal fracture callus has been investigated using a rabbit tibial fracture model and osteocalcin immunocytochemistry. The extraosseous tissues were isolated for study by reaming and nailing an osteotomy and excising 2 cm of periosteum on either side of the osteotomy. Specim...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199206000-00010
更新日期:1992-01-01 00:00:00
abstract::The conventional qualitative techniques of manual manipulation and plain radiography do not give a quantifiable measurement of healing. With internal fixation, manual manipulation is not usually possible, and conventional radiographs may not give much useful information, particularly if only a small amount of callus i...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199611000-00010
更新日期:1996-01-01 00:00:00
abstract::A unique case of an irreducible fracture dislocation of the knee is reported. A review of the literature revealed no previously reported cases of fracture dislocation of the distal femur not amenable to closed reduction. ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/00005131-199607000-00013
更新日期:1996-01-01 00:00:00
abstract:OBJECTIVES:The pathomorphology of posttraumatic acetabular dysplasia differs fundamentally from the classic developmental dysplasia of the adolescent. The aim of this report is to qualify and quantify the pathomorphologic characteristics of the posttraumatic acetabular dysplasia and to define the requirements for adequ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200009000-00004
更新日期:2000-09-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to determine the extent to which the Mangled Extremity Severity Score (MESS) predicted outcomes for soldiers sustaining combat-related Gustilo-Anderson type III open tibia fractures. DESIGN:Retrospective cohort study. SETTING:Tertiary trauma center. PATIENTS:Service Members w...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000054
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVES:To investigate the clinical and functional outcome in an elderly population with acetabular fractures after low-energy trauma treated acutely with a total hip arthroplasty supported by a reinforcement ring (Burch-Schneider antiprotrusion cage) and autologous bone grafting of the acetabulum. SETTING:Universi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200303000-00007
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVE:To determine if locking compression plates (LCP) are mechanically advantageous compared to low-contact dynamic compression plates (DCP) when used as a bridging plate in a synthetic model of osteoporotic bone. METHODS:Five synthetic bars (Synbone Osteoporotic bone) were initially tested in compression and the...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318160c84c
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVE:To describe in utero radiation exposures in pregnant patients undergoing acetabular fracture repair. DESIGN:Retrospective case series. SETTING:University-affiliated regional trauma center. PATIENT/PARTICIPANTS:Eight pregnant patients with acetabular fractures treated over a 6-year period. There were an add...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181847a42
更新日期:2008-09-01 00:00:00
abstract:OBJECTIVE:To determine the rate of pelvic vein thrombosis following acetabular or pelvic fracture identified by enhanced computed tomography venography or magnetic resonance venography. DESIGN:Prospective evaluation of computed tomography venography and magnetic resonance venography in patients with pelvic and acetabu...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200210000-00001
更新日期:2002-10-01 00:00:00
abstract:OBJECTIVE:Does immediate tibial nail insertion without reaming as part of protocol-driven management provide a safe and effective treatment for open tibia fractures? STUDY DESIGN:Prospective cohort. SETTING:Level 1 trauma center. PATIENTS:A consecutive series of 161 patients with Gustilo grade I-IIIb open tibia frac...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3180336923
更新日期:2007-03-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to evaluate forearm rotation after volar plating of the distal radius fractures with and without pronator quadratus repair. DESIGN:This was an institutional review board-approved retrospective review of prospectively collected data. SETTING:The study was conducted at an Academ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3182539333
更新日期:2013-03-01 00:00:00
abstract::Use of cephalomedullary nails is an option for treatment of subtrochanteric femur fractures. However, the magnitude of bending forces in this area of the femur often can lead to implant failure before union. We report on a case of hardware failure of a specific device (Synthes spiral blade) and a method for removal. ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199803000-00010
更新日期:1998-03-01 00:00:00
abstract:OBJECTIVES:Comparison of the effect of stainless steel and titanium low-contact dynamic compression plate application on the vascularity and mechanical properties of cortical bone after fracture. DESIGN:Randomized, prospective. SETTING:Orthopaedic research laboratory. ANIMALS:Ten large (greater than twenty-five kilo...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199710000-00006
更新日期:1997-10-01 00:00:00
abstract:OBJECTIVES:To relate the incidence of implant failure after internal anterior fixation of the pelvic ring to functional outcome and the health-related quality of life in patients. DESIGN:Retrospective chart and radiographic review. SETTING:Level I Trauma center. METHODS:We retrospectively identified all patients who...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000501
更新日期:2016-06-01 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:OBJECTIVE:To compare the biomechanical stability of extraarticular proximal tibia fractures reconstructed using a double-plate construct, locking plate system, hybrid external fixator, and single lateral periarticular plate, all from the same manufacturer. DESIGN:Standardized proximal tibial fractures (AO classificati...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200409000-00010
更新日期:2004-09-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to examine the results of computed tomography angiography (CTA) obtained in patients with high-energy tibial plafond fractures and assess if the information gleaned from CTA could be useful to the treating orthopedic surgeon. DESIGN:Consecutive patient series. SETTING:Level 2 t...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31815cf6e9
更新日期:2008-01-01 00:00:00
abstract::Autologous bone graft is usually necessary for reconstruction of nonunions with shortening or bone loss. We developed a new technique to reconstruct such nonunions or delayed unions without bone grafting by chipping and lengthening of bone at the original fracture site. Five in six nonunions with shortening or bone lo...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318041f6d1
更新日期:2007-07-01 00:00:00
abstract::Twenty-one patients with fractures of the ipsilateral femur and tibia were treated at Boston City Hospital from 1982 through 1987. Fourteen (67%) of the 21 patients sustained a total of 17 open fractures (76% of which were grade II or III wounds). Over 50% of the patients suffered concomitant ipsilateral knee injuries...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199004030-00013
更新日期:1990-01-01 00:00:00
abstract:OBJECTIVES:Malalignment has been frequently reported after intramedullary stabilization of distal tibia fractures. Nails have also been associated with knee pain in several studies. Historically, plate fixation has resulted in increased risks of infection and nonunion. Our purposes were to compare plate and nail stabil...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,随机对照试验
doi:10.1097/BOT.0b013e318213f709
更新日期:2011-12-01 00:00:00
abstract::This paper presents a modified surgical technique for interlocked intramedullary stabilization of tibia fractures. An external distractor is used to achieve an indirect fracture reduction on a fluoroscopy table. This method avoids the potential traction complications associated with conventional fracture tables. The f...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to report the efficacy of the Kapandji technique performed in the prone position for humeral supracondylar fractures in children. DESIGN:Retrospective. SETTING:Level I trauma center. PATIENTS/PARTICIPANTS:We retrospectively reviewed 34 children with Gartland type III supracond...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000015
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVES:To evaluate the reduction and outcome of selected intraarticular calcaneal fractures treated with percutaneous Essex-Lopresti reduction and fixation. DESIGN:Prospective consecutive series. SETTING:Level one trauma center and tertiary university hospital. PATIENTS/PARTICIPANTS:Twenty-six consecutive patien...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199809000-00007
更新日期:1998-09-01 00:00:00