B Almazedi1, C D Smith, D Morgan, G Thomas, G Pereira. 1. Department of Trauma and Orthopaedics, University Hospitals Coventry and Warwickshire NHS Trust, Clifford Bridge Road, Coventry, UK. b.almazedi@doctors.org.uk
Abstract
OBJECTIVE: This study aimed to define the role of the lateral X-ray in the assessment and treatment planning of proximal femoral fractures. Occult fractures were not included. METHODS: Radiographs from 359 consecutive patients with proximal femoral fractures admitted to our emergency department over a 12 month period were divided into anteroposterior (AP) views and lateral views. Three blinded reviewers independently assessed the radiographs, first AP views alone then AP plus lateral views, noting the fracture classification for each radiograph. These assessments were then compared with the intra-operative diagnosis, which was used as the gold standard. A 2 × 2 contingency square table was created and Pearson's χ(2) test was used for statistical analysis. RESULTS: The rate of correct classification by the reviewers was improved by the assessment of the lateral X-ray in addition to the AP view for intracapsular fractures (p<0.013) but not for extracapsular fractures (p=0.27). However, the only advantage obtained by assessing the lateral view in intracapsular fractures was the detection of displacement where the fracture appeared undisplaced on the initial AP view. CONCLUSION: This study provides statistical evidence that one view is adequate and safe for the majority of hip fractures. The lateral radiograph should not be performed routinely in order to make considerable savings in money and time and to avoid unnecessary patient discomfort.
OBJECTIVE: This study aimed to define the role of the lateral X-ray in the assessment and treatment planning of proximal femoral fractures. Occult fractures were not included. METHODS: Radiographs from 359 consecutive patients with proximal femoral fractures admitted to our emergency department over a 12 month period were divided into anteroposterior (AP) views and lateral views. Three blinded reviewers independently assessed the radiographs, first AP views alone then AP plus lateral views, noting the fracture classification for each radiograph. These assessments were then compared with the intra-operative diagnosis, which was used as the gold standard. A 2 × 2 contingency square table was created and Pearson's χ(2) test was used for statistical analysis. RESULTS: The rate of correct classification by the reviewers was improved by the assessment of the lateral X-ray in addition to the AP view for intracapsular fractures (p<0.013) but not for extracapsular fractures (p=0.27). However, the only advantage obtained by assessing the lateral view in intracapsular fractures was the detection of displacement where the fracture appeared undisplaced on the initial AP view. CONCLUSION: This study provides statistical evidence that one view is adequate and safe for the majority of hip fractures. The lateral radiograph should not be performed routinely in order to make considerable savings in money and time and to avoid unnecessary patient discomfort.
Authors: Natália Zalc Leonhardt; Lucas da Ponte Melo; David Gonçalves Nordon; Fernando Brandão de Andrade E Silva; Kodi Edson Kojima; Jorge Santos Silva Journal: Acta Ortop Bras Date: 2017 Mar-Apr Impact factor: 0.513
Authors: Matías Novillo; Fernando Díaz Dilernia; Gonzalo García Barreiro; Maria Lourdes Posadas-Martinez; Fernando Comba; Martin Buttaro Journal: Rev Fac Cien Med Univ Nac Cordoba Date: 2021-03-29