Pravesh Panchoo1,2, Maritz Laubscher3,4, Michael Held3,4, Sithombo Maqungo3,4,5, Nando Ferreira6, Hamish Simpson7, Simon Matthew Graham3,4,8,9. 1. Division of Orthopaedic Surgery, Groote Schuur Hospital, H49 Old Main Building, Observatory, Cape Town, South Africa. praveshpanchoo@gmail.com. 2. Orthopaedic Research Unit (ORU), University of Cape Town, Cape Town, South Africa. praveshpanchoo@gmail.com. 3. Division of Orthopaedic Surgery, Groote Schuur Hospital, H49 Old Main Building, Observatory, Cape Town, South Africa. 4. Orthopaedic Research Unit (ORU), University of Cape Town, Cape Town, South Africa. 5. Division of Global Surgery, University of Cape Town, Cape Town, South Africa. 6. Division of Orthopaedic Surgery, Stellenbosch University, Cape Town, South Africa. 7. Department of Orthopaedics and Trauma, University of Edinburgh, Edinburgh, UK. 8. Institute of Population Health Sciences, University of Liverpool, Liverpool, UK. 9. Department of Orthopaedics and Trauma Surgery, Liverpool University Teaching Hospital Trust, Liverpool, UK.
Abstract
OBJECTIVES: The Radiographic Union Score for Tibia (RUST) scoring system has been validated in multiple studies assessing the healing of tibial fractures. Our objective was to assess the interobserver and intraobserver reliability for the RUST in diaphyseal femoral fractures treated with intramedullary (IM) nailing. PATIENTS AND METHODS: A total of 60 sets of anteroposterior (AP) and lateral radiographs of diaphyseal femoral fractures treated by reamed IM nailing were randomly selected from a prospectively collected database. The 60 sets of radiographs were then scored by three reviewers using the RUST system. Interobserver reliability was measured at initial scoring. The 60 sets of radiographs were scored again by the three reviewers to calculate the intraobserver reliability. RESULTS: The RUST scores ranged from 4 to 12 with a mean score of 11.3 ± 1.3. The interobserver intraclass correlation coefficient (ICC) was 0.87 (95% CI, 0.81-0.92) and the intraobserver ICC was 0.91 (95% CI, 0.88-0.94), which indicated excellent agreement. CONCLUSION: This study demonstrated that the RUST system can be used reliably in the assessment of healing in diaphyseal femur fractures treated by reamed intramedullary nailing, with excellent interobserver and intraobserver reliability.
OBJECTIVES: The Radiographic Union Score for Tibia (RUST) scoring system has been validated in multiple studies assessing the healing of tibial fractures. Our objective was to assess the interobserver and intraobserver reliability for the RUST in diaphyseal femoral fractures treated with intramedullary (IM) nailing. PATIENTS AND METHODS: A total of 60 sets of anteroposterior (AP) and lateral radiographs of diaphyseal femoral fractures treated by reamed IM nailing were randomly selected from a prospectively collected database. The 60 sets of radiographs were then scored by three reviewers using the RUST system. Interobserver reliability was measured at initial scoring. The 60 sets of radiographs were scored again by the three reviewers to calculate the intraobserver reliability. RESULTS: The RUST scores ranged from 4 to 12 with a mean score of 11.3 ± 1.3. The interobserver intraclass correlation coefficient (ICC) was 0.87 (95% CI, 0.81-0.92) and the intraobserver ICC was 0.91 (95% CI, 0.88-0.94), which indicated excellent agreement. CONCLUSION: This study demonstrated that the RUST system can be used reliably in the assessment of healing in diaphyseal femur fractures treated by reamed intramedullary nailing, with excellent interobserver and intraobserver reliability.
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