RELIABILITY OF MULTIPLE RADIOLOGICAL UNION SCORING TOOLS IN HUMERAL DIAPHYSEAL FRACTURES: A PILOT STUDY
Notice bibliographique
Résumé
The primary aim of this study is to establish reliability of five different radiographic assessment tools currently used to evaluate union in humeral shaft fractures. The study will be the first to evaluate interobserver reliability of the radiographic union scale (RUST), modified RUST (mRUST), radiographic union score for HUmeral fractures (RUSHU), radiographic humerus union measurement (RHUM), and the modified radiographic union score (mRUS) in humeral diaphyseal fractures treated with both non-operative and operative management. This study aimed to establish which of the above radiographic union scoring methods has the highest reliability, to further inform future studies evaluating time to union for humeral diaphyseal fractures treated with both non-operative and operative treatment. A total of three orthopedic surgeons reviewed and scored radiographs from 17 patients with humeral diaphyseal fractures treated by non-operative management or open reduction and internal fixation using plate and screw constructs through an anterior or posterior approach. Radiographs were evaluated using the RUST, mRUST, RUSHU, RHUM, and mRUS at the 2- and 4-week follow-up, then at the 4-, 6-, and 12-month follow-up. After a minimum of a 4-week washout period, observers re-scored the radiographic assessment of fracture healing. Interobserver reliability of RUST, mRUST, RUSHU, RHUM and mRUS were determined using intraclass correlation coefficient (ICC). A total of 57 radiographs were reviewed from 17 patients, across the five follow-up timepoints. 52.9% were treated operatively, with either single or dual plate fixation. 47.1% were treated non-operatively, with splint or functional bracing. The intraclass correlation coefficient was computed to assess the agreement between raters in rating RUST, mRUST, mRUS, RUSHU and RHUM for each radiograph. RUST demonstrated poor absolute agreement between the raters, using the two-way random effect models and “single rater” unit, with an ICC of 0.46 (p=0.0001). In contrast, mRUST, mRUS, RUSHU and RHUM demonstrated moderate interrater agreement, with ICC of 0.65, 0.69, 0,54, and 0.61. The mRUS and mRUST scores demonstrated the highest performing agreement, which will help inform the use of the most reliable radiographic assessment tool for identification of fracture healing in the setting of humeral diaphyseal fractures treated non-operatively and operatively with a plate and screw technique. This study supports continued research with a larger cohort of patients and the evaluation of intra-rater reliability. This study will help inform the assessment of fracture healing in humeral shaft fractures treated both operatively and non-operatively. This will be used to inform determination of patients at risk of non-union in the clinical setting, as well as inform impact on functional outcomes in future research endeavours.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».