Objective assessment of plaster cast quality in pediatric distal forearm fractures: is there an optimal index?
Carregando...
Data
Título da Revista
ISSN da Revista
Título de Volume
Editor
Universidade Federal de Minas Gerais
Descrição
Tipo
Artigo de periódico
Título alternativo
Primeiro orientador
Membros da banca
Resumo
Background: Several so-called casting indices are available for objective evaluation of plaster cast quality.The present study sought to investigate four of these indices (gap index, padding index, Canterbury index,and three-point index) as compared to a reference standard (cast index) for evaluation of plaster cast quality after closed reduction of pediatric displaced distal forearm fractures.
Methods: Forty-three radiographs from patients with displaced distal forearm fractures requiring manipulation were reviewed. Accuracy, sensitivity, specificity, false-positive probability, false-negative probability, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio were calculated for each of the tested indices. Results: Comparison among indices revealed diagnostic agreement in only 4.7% of cases. The strongest correlation with the cast index was found for the gap index, with a Spearman correlation coefficient of 0.94. The gap index also displayed the best agreement with the cast index, with both indices yielding the same result in 79.1% of assessments. Conclusion: When seeking to assess plaster cast quality, the cast index and gap index should be calculated; if both indices agree, a decision on quality can be made. If the cast and gap indices disagree,the padding index can be calculated as a tiebreaker, and the decision based on the most frequent of the three results. Calculation of the three-point index and Canterbury index appears unnecessary.
Abstract
Assunto
Fraturas do Punho, Prognose, Pediatria
Palavras-chave
Distal forearm fracture, Casting indices, Prognosis, Pediatrics
Citação
Departamento
Curso
Endereço externo
https://www.sciencedirect.com/science/article/pii/S0020138316307847?via%3Dihub