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Ahmed M, Saad A, Bani-Khalid A, Sonsale P, Iyengar KP, Botchu R. The role of Grey Scale Inversion Imaging (GSII) as a diagnostic tool of neck of femur fractures: is it more effective? Emerg Radiol 2023; 30:419-423. [PMID: 37273151 DOI: 10.1007/s10140-023-02146-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 05/23/2023] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Grey Scale Inversion Imaging (GSII), a radiology reading software, has been utilized to improve anatomical and pathological delineation and consequently increase the diagnostic accuracy in a variety of trauma and Orthopaedic conditions. OBJECTIVE/AIM The objective of this study was to assess whether Grey Scale Inversion Imaging (GSII) has any impact on the diagnostic accuracy and inter-observer reliability in diagnosing neck of femur fractures. METHOD We performed a retrospective, single-centre study, to identify 50 consecutive anteroposterior (AP) pelvis radiographs of patients who presented to our unit with suspected neck of femur fractures between 2020 and 2021. The images included a combination of normal pelvic radiographs and others with features suggestive either intracapsular or extracapsular neck of femur fractures, which had been confirmed on computed tomography (CT), magnetic resonance imaging (MRI) and/or subsequent surgery. Four independent observers (two Trauma and Orthopaedics (T&O) consultants, one T&O Trainee Registrar (ST3 level) and one Trainee Senior House Officer (SHO in T&O) reviewed the images and graded each radiograph image using the Likert scale in response to the statement "there is a fracture". Following this, the same radiographs were inverted to Grey Scale Inversion Imaging (GSII) grey scale images and reassessed. RAND correlation was used for statistical analysis. RESULTS Overall, observers appeared to have similar accuracy with normal radiographic imaging and with GSI sequences. CONCLUSION Grey Scale Inversion Imaging (GSII) of digital radiographs did not affect the diagnostic accuracy of detecting neck of femur fractures in our study.
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Affiliation(s)
- Moustafa Ahmed
- Department of Orthopaedics, University Hospitals of Birmingham, Birmingham, UK
| | - Ahmed Saad
- Department of Orthopaedics, Royal Orthopedic Hospital, Birmingham, UK
| | - Aseel Bani-Khalid
- Department of Orthopaedics, University Hospitals of Birmingham, Birmingham, UK
| | - Paresh Sonsale
- Department of Orthopaedics, University Hospitals of Birmingham, Birmingham, UK
| | - K P Iyengar
- Department of Orthopaedics, Southport and Ormskirk Hospital NHS Trust, Southport, UK
| | - Rajesh Botchu
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Bristol Road South, Northfield, Birmingham, UK.
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Byun SE, Hwang J, Salameh M, Tucker NJ, Hadeed M, Heare A, Stacey SC, Mauffrey C, Parry JA. Three-Dimensional Computed Tomography Reconstructions Do Not Improve the Interobserver Reliability of the AO/Orthopaedic Trauma Association and Young and Burgess Pelvic Fracture Classifications. Indian J Orthop 2022; 56:1018-1022. [PMID: 35669025 PMCID: PMC9123096 DOI: 10.1007/s43465-022-00637-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 04/02/2022] [Indexed: 02/04/2023]
Abstract
Purpose To evaluate the value of three-dimensional (3D) computed tomography (CT) scans on the interobserver and intraobserver reliability of AO/Orthopaedic Trauma Association (OTA) and Young and Burgess (YB) classifications for pelvic ring injuries. Methods Seven reviewers (four fellowship-trained orthopaedic trauma surgeons and three fellows) independently classified 36 pelvic ring injuries using radiographs and axial two-dimensional (2D) CT scan images and then repeated this process 2 months later with the addition of 3D CT images. Interobserver and intraobserver reliability was assessed. Results The interobserver reliability of the AO/OTA classification using 2D vs. 3D CT scans was considered fair (k 0.23, CI 0.17-0.29) vs. slight (k 0.16, CI 0.09-0.22), with no observed difference [mean difference (MD) - 0.07, CI 0.16-0.01]. The interobserver reliability of the YB classification using 2D vs. 3D CT scans was considered fair for both (k 0.37, CI 0.32-0.42, vs. 0.37, CI 0.30-0.45), with no observed difference (MD - 0.0005, CI - 0.08 to 0.08). The intraobserver reliability of the AO/OTA vs. YB classifications was considered fair (k 0.35, CI 0.26-0.44) vs. moderate (k 0.49, CI 0.40-0.57), with the YB classification having higher kappa value (MD 0.13, CI 0.01-0.26, p = 0.03). Conclusion The addition of 3D CT scan reconstructions to radiographs and 2D CT did not improve the interobserver reliability of AO/OTA and YB classifications for pelvic ring injuries.
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Affiliation(s)
- Seong-Eun Byun
- Department of Orthopaedics, CHA Bundang Medical Center, Seongnam, Republic of Korea
| | - Jihyo Hwang
- Department of Orthopaedics, Gangnam Sacred Heart Hospital, University of Hallym School of Medicine, Seoul, Republic of Korea
| | - Motasem Salameh
- Department of Orthopaedic Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Nicholas J. Tucker
- Department of Orthopaedics, Denver Health Medical Center, University of Colorado School of Medicine, 777 Bannock St, MC 0188, Denver, CO 80204 USA
| | - Michael Hadeed
- Department of Orthopaedics, Denver Health Medical Center, University of Colorado School of Medicine, 777 Bannock St, MC 0188, Denver, CO 80204 USA
| | - Austin Heare
- Department of Orthopaedics, Denver Health Medical Center, University of Colorado School of Medicine, 777 Bannock St, MC 0188, Denver, CO 80204 USA
| | - Stephen C. Stacey
- Department of Orthopaedics, Denver Health Medical Center, University of Colorado School of Medicine, 777 Bannock St, MC 0188, Denver, CO 80204 USA
| | - Cyril Mauffrey
- Department of Orthopaedics, Denver Health Medical Center, University of Colorado School of Medicine, 777 Bannock St, MC 0188, Denver, CO 80204 USA
| | - Joshua A. Parry
- Department of Orthopaedics, Denver Health Medical Center, University of Colorado School of Medicine, 777 Bannock St, MC 0188, Denver, CO 80204 USA
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Xiao K, Xu B, Ding L, Yu W, Bao L, Zhang X, Chen M, Liu X, Lin H, Li T. Traditional versus mirror three-dimensional printing technology for isolated acetabular fractures: a retrospective study with a median follow-up of 25 months. J Int Med Res 2021; 49:3000605211028554. [PMID: 34187209 PMCID: PMC8258767 DOI: 10.1177/03000605211028554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective To assess the outcomes of traditional three-dimensional (3D) printing technology (TPT) versus mirror 3D printing technology (MTT) in treating isolated acetabular fractures (IAFs). Methods Consecutive patients with an IAF treated by either TPT or MTT at our tertiary medical centre from 2012 to 2018 were retrospectively reviewed. Follow-up was performed 1, 3, 6, and 12 months postoperatively and annually thereafter. The primary outcome was the Harris hip score (HHS), and the secondary outcomes were major intraoperative variables and key orthopaedic complications. Results One hundred fourteen eligible patients (114 hips) with an IAF (TPT, n = 56; MTT, n = 58) were evaluated. The median follow-up was 25 months (range, 21–28 months). At the last follow-up, the mean HHS was 82.46 ±14.70 for TPT and 86.30 ± 13.26 for MTT with a statistically significant difference. Significant differences were also detected in the major intraoperative variables (operation time, intraoperative blood loss, number of fluoroscopic screenings, and anatomical reduction number) and the major orthopaedic complications (loosening, implant failure, and heterotopic ossification). Conclusion Compared with TPT, MTT tends to produce accurate IAF reduction and may result in better intraoperative variables and a lower rate of major orthopaedic complications.
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Affiliation(s)
- Kai Xiao
- Department of Anesthesiology, 12443Huazhong University of Science and Technology, Wuhan Fourth Hospital; Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 473, Hanzheng Street, Qiaokou District, Wuhan, China
| | - Bo Xu
- Department of Cardiothoracic Surgery, The First Affiliated Hospital, Sun Yat-sen University, No. 58, Zhongshan 2nd Road, Yuexiu District, Guangzhou, China
| | - Lin Ding
- Department of Rehabilitation Medicine, 577528The Central Hospital of Wuhan, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, No. 26, Shengli Street, Jiang'an District, Wuhan, China
| | - Weiguang Yu
- Department of Orthopaedics, The First Affiliated Hospital, Sun Yat-sen University, No. 58, Zhongshan 2nd Road, Yuexiu District, Guangzhou, China
| | - Lei Bao
- Department of Anesthesiology, 12443Huazhong University of Science and Technology, Wuhan Fourth Hospital; Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 473, Hanzheng Street, Qiaokou District, Wuhan, China
| | - Xinchao Zhang
- Department of Orthopaedics, Jinshan Hospital, Fudan University, Longhang Road No. 1508, Jinshan District, Shanghai, China
| | - Meiji Chen
- Department of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, No. 58, Zhongshan 2nd Road, Yuexiu District, Guangzhou, China
| | - Xiangzhen Liu
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Sun Yat-sen University, No. 58, Zhongshan 2nd Road, Yuexiu District, Guangzhou, China
| | - Huanyi Lin
- Department of Urology Surgery, The First Affiliated Hospital, Sun Yat-sen University, No. 58, Zhongshan 2nd Road, Yuexiu District, Guangzhou, China
| | - Tengfei Li
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, No. 58, Zhongshan 2nd Road, Yuexiu District, Guangzhou, China
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Fractures of the acetabulum: from yesterday to tomorrow. INTERNATIONAL ORTHOPAEDICS 2020; 45:1057-1064. [PMID: 32964295 PMCID: PMC8052228 DOI: 10.1007/s00264-020-04806-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 09/08/2020] [Indexed: 11/17/2022]
Abstract
Purpose The aim of this article is to present history, state of the art, and future trends in the treatment of acetabular fractures. Methods Review of recent and historical literature. Results Acetabular fractures are difficult to treat. The first descriptions of this injury already appeared in ancient Greek history, but intensive development started in the second half of the twentieth century after Judet and Letournel’s seminal work. Their classification is still the gold standard today. It is actually a pre-operative planning system and is used to determine the most appropriate surgical approach. The therapy of choice for dislocated fractures is open reduction and internal fixation. Recent modern techniques based on high-tech computerized planning systems and 3D printing have been successfully integrated into orthopaedic trauma practice. Conclusion There is no ideal surgical approach for acetabulum fracture treatment, so new approaches have been developed in recent decades. The best outcome series have shown good or excellent results, between 70 and 80%.
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