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A-0047 How Reliable is the Radiographic Diagnosis of Mild Madelung Deformity?
Sebastian Farr 1, Thierry G. Guitton 2, David Ring 3, Science of Variation Group, 1 Orthopedic Hospital Speising, Vienna, Austria; 2 University Medical Center, Groningen, The Netherlands; 3 Dell Medical School - The University of Texas, Austin, TX, USA
Thursday, June 14, 2018 · 8:17 a.m. · 05m 13s
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more than a good chance like disenchantment um we know from the previously church at that
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um manning deformity has a new spectrum from mild cases to sea view cases
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and you can see from the previous literature that there is a white overlap so you can see
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well not till to one of the most important barometers and uh ranges from
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fifteen to fifty degrees learned subsidence for minus ten to eleven degrees
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stargazer very brought the a spectrum of deformity and for that reason uh
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a classification in a a distant type in an anti ad type may not be enough for this uh
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a special deformity and you can see here what i mentioned before
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the white overlap from the parameters from cases which uh
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uh are healthy or seem to be healthy and also seem to be passed the logic sort there's a broad overlap
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in the most important parameter so just that we
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noted subsidence false angle and part macabre displacement
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so for that reason when can we call it the man along deformity that's not very
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clear or at least and for don't mind the cases it's not so clear
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there have been studies to word evaluated an animus agreement of another
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long deformity and some uh caught of parameters have been established
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however we can assume that there is a higher incidence of a madman
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among deformity which may be a responsible for nonspecific grease paint
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of course so you should not over treaties cases if they have no clinical relevance
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and the um if the diagnosis of these cases is not reliable then uh
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the relevance is decreased even more so for that reason we ask that
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if the radio graphic diagnosis of mild modern deformities on reliable or not
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we didn't online survey to members of the signs variation group a groove
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up a of a hand the trauma surgeons another big surgeons worldwide
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we chose twenty five p. a. radio breasts uh twenty
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normal uh hands and wrists and five with
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the suspected mouse problem deformity they were chosen from
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this overlap zone which i mentioned before
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and the the surgeons were asked whether they think it's amount model them
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yes or no one how about their doubt uh in this rating
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and uh we did a lot of statistics for that you can see on the left and
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on the middle image such a case which uh with a very steep let all
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where you could can assume that it might be some case of a mile malone
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deformity as compared to the right side which is and will be strong
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so we had a total for sixty nine completed surveys um
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most of them are from north america and europe
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and um we have an overall sensitivity of just the zero
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point three overall specificity of zero point eighty six
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a and the overall accuracy was the zero point seventy
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five so positive and negative predictive value server
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a zero point three eight and a point the aid for the overall in total
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agreement so the couple was very low is consumed with a zero point twelve
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however the confidence in the diagnosis was quite high so the raiders were confident
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whatever to win whatever rating and the even uh for um the
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normal cases that the confidence was just a little bit
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higher than for the suspected mile long cases
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on average we had a four point three radio crafts diagnosed with the modern no although fifteen
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observers said that there was no martin on um on the twenty five radio right
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and the only predicting the regression and slices which was really significant was
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the rate the confidence that to predict the uh wrestled thought so
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so uh in the discussion we can say that we don't know the
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exact prevalence of modern warm out another long it's uncertain we
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don't know if it might do some symptoms or does come for
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a baby practised or is it just and then finding
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and as a we say uh from the current literature there are no a reliable parameters
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to really define risk that age when there is a mile deformity and why not
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um so uh up to date we can say just patients with
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this nonspecific with in should be a trick that support roughly
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however we have to mention that they're rubber limitations to the study of
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course uh with uh the reference consensus by two surgeons so
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um the prevalence uh in that that's a normal
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population overpopulation of would be most likely much
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um well what in in our study so this would make that negative predictive value higher
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and uh we had no veteran images included in this not because
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most of the parameters which words that just aren't eight p.
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use so therefore we chose to make it easy and just to
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distribute the a. p. x. rays to the the surgeons
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so uh in conclusion we can say from this study that mao adult model on the form it can
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