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A-1113 CT-scans alter treatment in 33% of scaphoid fractures deemed undisplaced by conventional x-rays
Johannes Heindl 1, Jesper Sonntag 2, Per Rasmussen 2, Per Hølmer 2, Birgit Waschulzik 3, Claus Hjorth Jensen 4, Anders Klahn 2, 1 Lakumed Clinic Landshut-Achdorf, Germany; 2 Nordsjaellands Hospital, Hillerød, Denmark; 3 Institute of Medical Informatics, Statistics and Epidemiology, Munich, Germany; 4 Herlev-Gentofte University Hospital of Copenhagen, Denmark
Thursday, June 14, 2018 · 8:58 a.m. · 03m 59s
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study and c. t. scanning of non displaced effort factors diagnosed primary language depressed business goes
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the objective of my study was and to investigate how c. t. scans of initially
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non displaced effort fractures that i noticed on the plane x. rays effective treatment plan for these fractures
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so the background is what will hurt for a is an issue electric shock
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to be unreliable surfaced out about factor alignment to piss you just can
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so the method was the readers but the structure of the medical records for
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patients registered for school uh suspects graphic factors at an utterance but so
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and then we'll database review and we excluded uh will discuss what factors that had an incomplete
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um data set we excluded those patients that percent of more than four weeks after the trauma
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and uh we exclude those patients by the time interval between rated resin c. t. was
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more than seven days and then in the end we could include seventy patients
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amateur animal station and then and then my station of the x. rays
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and the c. t. scans and and we did every separate retrospective
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album evaluation by choosing a hand surgeon and they have to decide
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of this stuff attraction should be treated approach if we're conservatively
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and a recommended operative treatment in all the uh displaced unstable and
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uh approximates comfort factors and what were the shots my studies first of all the
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non displacement on initial rated press uh also want trudged i'm fifty three
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i'm scott projects to be non displaced an observer to a charged a
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fifty eight to be an on this place and they had
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an agreement on fifty one patients and um this fifty one page
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patient would had an agreement we took a closer look
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um so what you can see here for so one there was a change and we pump men in a a twelve
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out of fifty one scuff attraction meaning twenty four percent and what we can see that was
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for to one that was a tendency uh two words operative cream and while for so to uh we
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had a change and people can eight out of fifty once covered factions meaning sixteen percent and
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there was actually a tendency towards more conservative treatment that's that's why we
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uh um that another table um and in this a table
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can seem in the beginning of a bit confusing but you can see here is the the agreement on the conservative treatment
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according to the right address is highlighted blue and the agreement
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on the operatives treatment according to radio addresses highlighted red
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you can check to see the change in the treatment plan after the relation in
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c. t. not we can see here that only in thirty one plus three
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uh fractures meaning thirty four out of fifty one factors in sixty seven percent we had an agreement between
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radio address and c. t. according um for for the treatment plant
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and all the others seventeen cases um there was a change in treatment
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plan and in only two of the seventeen both observers agreed
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so again uh the uh in six seven percent both observers had the same treatment plant
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and in seventeen of fifty once covered factors to trip and was a change by either one or both observers that's why
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be of course took a look at the inter observer liability for the treatment and why during the whole study did
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into observer ability was from mostly moderate to substantial we
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had fixed up a treatment plan in these
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initial non displaced factors andre depressed we had a couple value of zero point
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four six for for the x. rays and actually a couple of zero
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point two nine for the c. t. scan some meaning only fair agreement on
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c. t. scans um and the conclusion of the study was that
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c. t. scans should be routinely employed in the diagnosis and treatment of a scaffold factors
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and we definitely in need a better evaluation methods um and education of
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