Reliability of the radiographic union scale in tibial fractures (RUST)

Filho, Fernando Antonio Silva de Azevedo; Cotias, Ricardo Britto; Azi, Matheus Lemos; Teixeira, Armando Augusto de Almeida

doi:10.1016/j.rboe.2016.05.006

Cited by 14 publications

(15 citation statements)

References 18 publications

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“…Each of the cortices (four total) on the AP and lateral radiographs were graded as: 1 = No callus; 2 = Callus present without bridging; 3 = Bridging callus, but visible fracture line; 4 = Fracture line not visible (remodeled). The mRUST score is the sum of the four cortical scores (range, [4][5][6][7][8][9][10][11][12][13][14][15][16]. Each cortex was scored individually.…”

Section: Methodsmentioning

confidence: 99%

“…Several studies assessing the utility of the RUST and/or mRUST have considered them to be "valid" or "valid and reliable" in adult patients with tibia diaphyseal fractures treated with IMN. [4][5][6][7][8][9][10] RUST and/or mRUST criteria have also been applied in other patient populations such as in pediatric Osteogenesis Imperfecta patients, 11 pediatric congenital tibial pseudoarthrosis (Neurofibromatosis Type I) patients, 12 and adult high-tibial osteotomy patients (modification of RUST criteria). 13 However, no published studies have examined the reliability of any cortical scoring system in patients with bone defects, nor in a cohort of patients treated with definitive external fixation.…”

Section: Introductionmentioning

confidence: 99%

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Inter-Rater Reliability of the Modified Radiographic Union Score for Diaphyseal Tibial Fractures With Bone Defects

Mitchell

Obremskey

Luly

et al. 2019

Journal of Orthopaedic Trauma

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To evaluate inter-rater reliability of the modified Radiographic Union Score for Tibial (mRUST) fractures among patients with open, diaphyseal tibia fractures with a bone defect treated with intramedullary nails (IMNs), plates, or definitive external fixation (ex-fix). Design: Retrospective cohort study.Setting: 15 level one civilian trauma centers; 2 military treatment facilities.Patients/Participants: Patients ≥18-years-old with open, diaphyseal tibia fractures with a bone defect ≥1 centimeter surgically treated between 2007 and 2012.Intervention: Three of six orthopaedic traumatologists reviewed and applied mRUST scoring criteria to radiographs from the last clinical visit within 13 months of injury.Main Outcome Measurements: Inter-rater reliability was assessed using Krippendorff's Alpha (KA) statistic; Intraclass correlation coefficient (ICC) is presented for comparison to previous publications.Results: 213 patients met inclusion criteria including 115 IMNs, 24 plates, 29 ex-fixes, and 45 cases that no longer had instrumentation at evaluation. All reviewers agreed on the pattern of scoreable cortices for 90.4% of IMNs, 88.9% of those without instrumentation, 44.8% of rings, and 20.8% of plates. Thirty-one (15%) cases, primarily plates and ex-fixes, did not contribute to KA and ICC estimates because <2 raters scored all cortices. The overall KA for the 85% that could be analyzed was 0.64 (ICC 0.71). For IMNs, plates, ex-fixes, and no instrumentation, KA (ICC) was 0.65 (0.75), 0.88 (0.90), 0.47 (0.62), and 0.48 (0.57), respectively. Conclusions:In tibia fractures with bone defects, the mRUST appears similarly reliable to prior work in patients treated with IMN but is less reliable in those with plates or ex-fixes, or after removal of instrumentation.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Inter-Rater Reliability of the Modified Radiographic Union Score for Diaphyseal Tibial Fractures With Bone Defects

Mitchell

Obremskey

Luly

et al. 2019

Journal of Orthopaedic Trauma

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“…These injuries result from high-energy trauma, such as fall from height and car accidents; the latter are a major cause of fractures and lead to disability, with high socioeconomic costs. [ 1 ] Proximal and distal tibial fractures with a compromised soft tissue envelop still pose a treatment dilemma or challenge for the orthopedic surgeon. [ 2 – 4 ] Treatment methods include conservative management, internal fixation, and the use of external fixation devices.…”

Section: Introductionmentioning

confidence: 99%

Locked plating as an external fixator in treating tibial fractures

Luo

Ding

et al. 2017

Medicine

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Objectives:This article is a systematic review of the published literature about the biomechanics, functional outcomes, and complications of a locked plate as an external fixator in treating tibial fractures.Methods:We searched the PubMed, Ovid Medline, Embase, ScienceDirect, and Cochrane Library databases to retrieve the relevant studies. Studies published in English and Chinese which assessed adult patients and more than 4 cases who had sustained any type of fresh tibial fracture treated with the external locking plate, provided that they reported functional outcomes, range of motion (ROM), union or complication rates, and the biomechanical studies of external locked plating are also included.Results:The electronic search strategy revealed 248 studies, and 2 studies were identified as relevant through manual search of references. Finally, 12 studies were included in this systematic review. These consist of 3 pure biomechanical studies, 8 case series, and 1 study including both of biomechanics and case series. Due to the heterogeneity of biomechanical studies, we can only conclude that external locked plate shows inferior structural stiffness than internal locked plate. The clinical studies reported that external locked plating gave a satisfactory ROM of the knee and ankle, functional outcomes, union rate, and low complication rate.Conclusions:We can only conclude that external locked plate shows inferior structural stiffness than internal locked plate because of the heterogeneity of biomechanical studies. The clinical studies showed locked plating as an external fixator in treating tibial fractures can be considered as a safe and successful procedure. However, as yet, there is unconvincing evidence that it is superior to standard techniques with regards to clinical and functional outcomes. More and well-designed studies about this technique should be carried out.

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“…A consolidação foi definida como a formação de calos de ponte em pelo menos três corticais em duas projeções radiográficas (anteroposterior e perfil) por meio do escore Reliability of the Radiographic Union Scale in Tibial Fractures (RUST, na sigla em inglês), expandido para a consolidação de fraturas femorais. 11 A ausência de sinais radiográficos de consolidação, após ! 6 meses de pós-operatório, foi definida como pseudoartrose.…”

Section: Level Of Evidenceunclassified

Fraturas atípicas do fêmur associadas ao uso crônico de bisfosfonatos: Uma série de casos de 66 pacientes

Falótico

Cunza

Ferreira

et al. 2021

Rev Bras Ortop (Sao Paulo)

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Resumo Objetivo Descrever os resultados de uma série de pacientes tratados cirurgicamente com diagnóstico de fratura femoral atípica associada ao uso de bisfosfonatos, assim como correlacionar o tempo de uso prévio da medicação com o tempo de consolidação da fratura e comparar o tempo de consolidação das fraturas completas e incompletas. Métodos Trata-se de um estudo observacional e retrospectivo de 66 pacientes com diagnóstico de fratura atípica do fêmur associada ao uso crônico de bisfosfonatos. Os pacientes foram submetidos ao tratamento cirúrgico ortopédico em hospital de referência no período de janeiro de 2018 a março de 2020. Resultados Os pacientes incluídos no estudo eram todos do sexo feminino, com dois casos bilaterais. A consolidação da fratura ocorreu em todos os casos com tempo médio de 2,3 meses e seguimento de 5,8 meses. O tempo médio de uso de bisfosfonatos foi de 7,8 anos. Não houve correlação do tempo de uso prévio de bisfosfonatos com o tempo de consolidação das fraturas. Houve uma diferença do tempo de consolidação entre as fraturas completas e incompletas. Conclusão Houve consolidação após tratamento cirúrgico com haste cefalomedular longa em todos os pacientes do presente estudo, sendo o tempo de consolidação maior nas fraturas completas em relação às incompletas, e não houve correlação entre o tempo de uso prévio de bisfosfonatos e o tempo de consolidação. Nível de evidência Nível IV, série de casos

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Reliability of the radiographic union scale in tibial fractures (RUST)

Cited by 14 publications

References 18 publications

Inter-Rater Reliability of the Modified Radiographic Union Score for Diaphyseal Tibial Fractures With Bone Defects

Inter-Rater Reliability of the Modified Radiographic Union Score for Diaphyseal Tibial Fractures With Bone Defects

Locked plating as an external fixator in treating tibial fractures

Fraturas atípicas do fêmur associadas ao uso crônico de bisfosfonatos: Uma série de casos de 66 pacientes

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