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- W2029207714 abstract "Gaskin et al. 1 Gaskin J.S.H. Pimple M.K. Wharton R. et al. How accurate and reliable are doctors in estimating fracture angulation?. Injury. 2007; 38: 160-162 Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar have demonstrated the problem with the interpretation of angulation of fractures using radiographs. A few points come to mind. 1.The authors claim that doctors often estimate fracture angulation without a goniometer. I assume this is from their own experience, as this point is not referenced. The decision to operate (i.e. manipulate under anaesthesia) or treat non-operatively is significant, particularly with respect to operative risks and parental anxiety. Therefore, in my practice and experience it is not sufficient to estimate angulation, and I would use a goniometer. 2.The authors have not acknowledged that even with the use of measuring devices, there can be inter- and intra-observer variability, 2 Ruf J. Craig C.L. Kuhns L. et al. Radiographic assessment of pediatric proximal radius fractures: interrater and intrarater reliability. J Pediatr Orthop. 2005; 25: 588-591 Crossref PubMed Scopus (5) Google Scholar which one would therefore see when subjects estimate fracture angulation. 3.Guidelines for the assessors have not been detailed. This is most relevant to the inexperienced assessors, who may estimate the fracture angulation as the angle created at the fracture site between the proximal and distal cortex, rather than the angle between a line perpendicular to long axis of the radius and the distal articular surface. I note that the pre-registration house officers had no previous experience in orthopaedics. 4.The study may now be a little dated with the widespread introduction of picture archiving and communication systems (PACS). With ‘hard-copy’ radiographs, one tends to estimate fracture angulation due to a lack of a goniometer. Fortunately, most PACS software is equipped with on-screen angle measurers, and so one should not need to estimate. However, one may need to ensure that there is not significant observer variability when using these." @default.
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- W2029207714 date "2008-02-01" @default.
- W2029207714 modified "2023-09-26" @default.
- W2029207714 title "Fracture angulation—What about modern technology?" @default.
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- W2029207714 doi "https://doi.org/10.1016/j.injury.2007.07.032" @default.
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