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Measurement of Clavicle Fracture Shortening Using Computed Tomography and Chest Radiography
BACKGROUND: Nonoperative management of midshaft clavicle fractures has resulted in widely disparate outcomes and there is growing evidence that clavicle shortening poses the risk of unsatisfactory functional outcomes due to shoulder weakness and nonunion. Unfortunately, the literature does not clear...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Orthopaedic Association
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5114247/ https://www.ncbi.nlm.nih.gov/pubmed/27904717 http://dx.doi.org/10.4055/cios.2016.8.4.367 |
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author | Omid, Reza Kidd, Chris Yi, Anthony Villacis, Diego White, Eric |
author_facet | Omid, Reza Kidd, Chris Yi, Anthony Villacis, Diego White, Eric |
author_sort | Omid, Reza |
collection | PubMed |
description | BACKGROUND: Nonoperative management of midshaft clavicle fractures has resulted in widely disparate outcomes and there is growing evidence that clavicle shortening poses the risk of unsatisfactory functional outcomes due to shoulder weakness and nonunion. Unfortunately, the literature does not clearly demonstrate the superiority of one particular method for measuring clavicle shortening. The purpose of this study was to compare the accuracy of clavicle shortening measurements based on plain radiographs with those based on computed tomography (CT) reconstructed images of the clavicle. METHODS: A total of 51 patients with midshaft clavicle fractures who underwent both a chest CT scan and standardized anteroposterior chest radiography on the day of admission were included in this study. Both an orthopedic surgeon and a musculoskeletal radiologist measured clavicle shortening for all included patients. We then determined the accuracy and intraclass correlation coefficients for the imaging modalities. Bland-Altman plots were created to analyze agreement between the modalities and a paired t-test was used to determine any significant difference between measurements. RESULTS: For injured clavicles, radiographic measurements significantly overestimated the clavicular length by a mean of 8.2 mm (standard deviation [SD], ± 10.2; confidence interval [CI], 95%) compared to CT-based measurements (p < 0.001). The intraclass correlation was 0.96 for both plain radiograph- and CT-based measurements (p = 0.17). CONCLUSIONS: We found that plain radiograph-based measurements of midshaft clavicle shortening are precise, but inaccurate. When clavicle shortening is considered in the decision to pursue operative management, we do not recommend the use of plain radiograph-based measurements. |
format | Online Article Text |
id | pubmed-5114247 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | The Korean Orthopaedic Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-51142472016-12-01 Measurement of Clavicle Fracture Shortening Using Computed Tomography and Chest Radiography Omid, Reza Kidd, Chris Yi, Anthony Villacis, Diego White, Eric Clin Orthop Surg Original Article BACKGROUND: Nonoperative management of midshaft clavicle fractures has resulted in widely disparate outcomes and there is growing evidence that clavicle shortening poses the risk of unsatisfactory functional outcomes due to shoulder weakness and nonunion. Unfortunately, the literature does not clearly demonstrate the superiority of one particular method for measuring clavicle shortening. The purpose of this study was to compare the accuracy of clavicle shortening measurements based on plain radiographs with those based on computed tomography (CT) reconstructed images of the clavicle. METHODS: A total of 51 patients with midshaft clavicle fractures who underwent both a chest CT scan and standardized anteroposterior chest radiography on the day of admission were included in this study. Both an orthopedic surgeon and a musculoskeletal radiologist measured clavicle shortening for all included patients. We then determined the accuracy and intraclass correlation coefficients for the imaging modalities. Bland-Altman plots were created to analyze agreement between the modalities and a paired t-test was used to determine any significant difference between measurements. RESULTS: For injured clavicles, radiographic measurements significantly overestimated the clavicular length by a mean of 8.2 mm (standard deviation [SD], ± 10.2; confidence interval [CI], 95%) compared to CT-based measurements (p < 0.001). The intraclass correlation was 0.96 for both plain radiograph- and CT-based measurements (p = 0.17). CONCLUSIONS: We found that plain radiograph-based measurements of midshaft clavicle shortening are precise, but inaccurate. When clavicle shortening is considered in the decision to pursue operative management, we do not recommend the use of plain radiograph-based measurements. The Korean Orthopaedic Association 2016-12 2016-11-04 /pmc/articles/PMC5114247/ /pubmed/27904717 http://dx.doi.org/10.4055/cios.2016.8.4.367 Text en Copyright © 2016 by The Korean Orthopaedic Association http://creativecommons.org/licenses/by-nc/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Omid, Reza Kidd, Chris Yi, Anthony Villacis, Diego White, Eric Measurement of Clavicle Fracture Shortening Using Computed Tomography and Chest Radiography |
title | Measurement of Clavicle Fracture Shortening Using Computed Tomography and Chest Radiography |
title_full | Measurement of Clavicle Fracture Shortening Using Computed Tomography and Chest Radiography |
title_fullStr | Measurement of Clavicle Fracture Shortening Using Computed Tomography and Chest Radiography |
title_full_unstemmed | Measurement of Clavicle Fracture Shortening Using Computed Tomography and Chest Radiography |
title_short | Measurement of Clavicle Fracture Shortening Using Computed Tomography and Chest Radiography |
title_sort | measurement of clavicle fracture shortening using computed tomography and chest radiography |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5114247/ https://www.ncbi.nlm.nih.gov/pubmed/27904717 http://dx.doi.org/10.4055/cios.2016.8.4.367 |
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