Lateral X-ray for proximal femoral fractures – Is it really necessary?

Riaz, Osman; Nisar, Sohail; Arshad, Rizwan; Vanker, R

doi:10.1016/j.surge.2015.07.005

Cited by 8 publications

(9 citation statements)

References 7 publications

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“…Almazedi et al 4 showed that adding a lateral x-ray to the anteroposterior view increases the sensitivity of diagnosis for displacement fractures from 53% to 91%, and specificity from 88% to 91% in proximal femur fractures. Riaz et al 5 confirmed these findings in a similar study. Both concluded that profile x-rays were effective in differentiating displacement fractures that did not appear to be displaced in the anteroposterior view, but they did not alter procedure in the cases in which the anteroposterior view showed a fracture with displacement.…”

Section: Discussionsupporting

confidence: 53%

Femoral Neck Fractures Garden I and Ii: Evaluation of the Deviation in Lateral View

et al. 2017

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Objective: To evaluate the rate of deviation in the lateral radiographic incidence in patients with femoral neck fracture classified as non-diverted in the anteroposterior view (Garden I and II). Methods: Nineteen selected patients with femoral neck fractures classified as Garden I and II were retrospectively evaluated, estimating the degree of deviation in the lateral view. Results: Fifteen cases (79%) presented deviations in lateral view, with a mean of 18.6 degrees (±15.5). Conclusion: Most fractures of the femoral neck classified as Garden I and II present some degree of posterior deviation in the X-ray lateral view. Level of Evidence III, Retrospective Comparative Study.

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Section: Discussionsupporting

confidence: 53%

Femoral Neck Fractures Garden I and Ii: Evaluation of the Deviation in Lateral View

et al. 2017

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“…Tras analizar los datos recolectados y al compararlos con otros estudios [5,6], que sugieren que la radiografía P sólo es útil para aquellas fracturas categorizadas en la AP como no desplazadas, nosotros disentimos. La radiografía P es útil también en aquellas fracturas catalogadas como desplazadas, ya que como se pudo observar, 1 de nuestros pacientes cuya fractura fue clasificada como desplazada en la AP, tras analizar el P, fue recategorizada como no desplazada.…”

Section: Discussionunclassified

¿Es necesaria la incidencia radiográfica de perfil para clasificar las fracturas mediales de cadera? Análisis intra e inter observador utilizando la clasificación de Garden

Novillo

Dilernia

Barreiro

et al. 2021

Rev Fac Cien Med Univ Nac Cordoba

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INTRODUCCIÓN: Históricamente, el diagnóstico de una fractura medial de cadera requiere de una radiografía anteroposterior (AP) y de perfil (P). Nos propusimos analizar la importancia de la radiografía de perfil en la evaluación y planificación del tratamiento de las fracturas mediales de cadera, utilizando la clasificación de Garden. MATERIALES Y MÉTODOS: Se prepararon diapositivas con radiografías AP y de P de 100 pacientes con fracturas mediales de cadera admitidos en nuestra central de emergencias. Tres cirujanos de cadera evaluaron de forma independiente las incidencias AP únicamente y luego las vistas AP y P, utilizando la clasificación de Garden. RESULTADOS: Se utilizó el método de Kruskal Wallis para comparar los rangos en la clasificación de Garden después de ver la proyección de P y no se encontraron diferencias estadísticamente significativas (Kruskal Wallis 0, p=1). El acuerdo ponderado entre AP y el AP combinado con el P del Garden promedio fue de 81 % (p < 0.001). Se analizó el porcentaje de pacientes recategorizados entre fracturas no desplazadas y desplazadas, tras observar el perfil: 5% (n=5, IC 95% 1-11%) . Para comparar el Garden AP con el Garden P, se utilizó el método kappa ponderado cuadrático. CONCLUSIONES: Existe una alta concordancia en la clasificación de Garden al comparar las observaciones de las radiografías AP, con las observaciones AP y P juntas. Cinco pacientes hubiesen recibido un tratamiento quirúrgico diferente dependiendo del especialista que interpretaba las radiografías. Esto permite destacar la importancia de solicitar la incidencia de perfil de rutina en pacientes con sospecha de fractura medial de cadera. palabras clave: cadera; fracturas de cadera; prótesis de cadera; lesiones de la cadera; radiografía

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“…Following abstract review, 89 articles were progressed to full-text review. A total of 23 articles were included for qualitative synthesis, of which 10 articles yielded data suitable for meta-analysis [12][13][14][15][16][17][18][19][20][21]. These 10 articles examined an aggregate of 3902 sets of radiographs, producing a total of 4709 radiograph interpretation episodes for metaanalysis (see Fig.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…This included soft tissue injury, fractures, dislocations, osteomyelitis and osteoporosis. The other nine articles defined positive and negative finding as the presence or absence of a bony fracture [12,13,[15][16][17][18][19][20][21]. However, two of these nine articles went further and required radiograph interpreters to correctly classify any fracture identified for their findings to be regarded as a 'true' positive.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

Reporting errors in plain radiographs for lower limb trauma—a systematic review and meta-analysis

York

Franklin²,

Reynolds³

et al. 2021

Skeletal Radiol

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Introduction Plain radiographs are a globally ubiquitous means of investigation for injuries to the musculoskeletal system. Despite this, initial interpretation remains a challenge and inaccuracies give rise to adverse sequelae for patients and healthcare providers alike. This study sought to address the limited, existing meta-analytic research on the initial reporting of radiographs for skeletal trauma, with specific regard to diagnostic accuracy of the most commonly injured region of the appendicular skeleton, the lower limb. Method A prospectively registered, systematic review and meta-analysis was performed using published research from the major clinical-science databases. Studies identified as appropriate for inclusion underwent methodological quality and risk of bias analysis. Meta-analysis was then performed to establish summary rates for specificity and sensitivity of diagnostic accuracy, including covariates by anatomical site, using HSROC and bivariate models. Results A total of 3887 articles were screened, with 10 identified as suitable for analysis based on the eligibility criteria. Sensitivity and specificity across the studies were 93.5% and 89.7% respectively. Compared with other anatomical subdivisions, interpretation of ankle radiographs yielded the highest sensitivity and specificity, with values of 98.1% and 94.6% respectively, and a diagnostic odds ratio of 929.97. Conclusion Interpretation of lower limb skeletal radiographs operates at a reasonably high degree of sensitivity and specificity. However, one in twenty true positives is missed on initial radiographic interpretation and safety netting systems need to be established to address this. Virtual fracture clinic reviews and teleradiology services in conjunction with novel technology will likely be crucial in these circumstances.

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Lateral X-ray for proximal femoral fractures – Is it really necessary?

Cited by 8 publications

References 7 publications

Femoral Neck Fractures Garden I and Ii: Evaluation of the Deviation in Lateral View

Femoral Neck Fractures Garden I and Ii: Evaluation of the Deviation in Lateral View

¿Es necesaria la incidencia radiográfica de perfil para clasificar las fracturas mediales de cadera? Análisis intra e inter observador utilizando la clasificación de Garden

Reporting errors in plain radiographs for lower limb trauma—a systematic review and meta-analysis

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