Objective assessment of plaster cast quality in pediatric distal forearm fractures: Is there an optimal index?

详细信息    查看全文

• 作者：Pedro José ; Labronici^a ; ^b ; ^{plabronici@globo.com} ; ^{robinsonesteves@ig.com.br} ; Leonardo Termis Ferreira^b ; Fernando Claudino dos Santos Filho^b ; Robinson Esteves Santos Pires^c ; Davi Coutinho Fonseca Fernandes Gomes^d ; Luiz Henrique Penteado da Silva^e ; Vinicius Schott Gameiro^f
• 关键词：Distal forearm fracture ; Casting indices ; Prognosis ; Pediatrics
• 刊名：Injury
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：48
• 期：2
• 页码：552-556
• 全文大小：732 K
• 卷排序：48

文摘

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.MethodsForty-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.ResultsComparison 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.ConclusionWhen 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.