Influence of radiographic projection and patient positioning on shortening of the fractured clavicle
Background: Radiographic measurements of shortening and vertical displacement in the fractured clavicle are subject to a variety of factors such as patient positioning and projection. The aims of this study were (1) to quantify differences in shortening and vertical displacement in varying patient p...
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| Format: | Article |
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Elsevier
2020-09-01
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| Series: | JSES International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666638320300402 |
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| author | Paul Hoogervorst, MD Arnoud van Geene, MD Udo Gundlach, MD Abel Wei, MD Nico Verdonschot, PhD Gerjon Hannink, PhD |
| author_facet | Paul Hoogervorst, MD Arnoud van Geene, MD Udo Gundlach, MD Abel Wei, MD Nico Verdonschot, PhD Gerjon Hannink, PhD |
| author_sort | Paul Hoogervorst, MD |
| collection | DOAJ |
| description | Background: Radiographic measurements of shortening and vertical displacement in the fractured clavicle are subject to a variety of factors such as patient positioning and projection. The aims of this study were (1) to quantify differences in shortening and vertical displacement in varying patient positions and X-ray projections, (2) to identify the view and patient positioning indicating the largest amount of shortening and vertical displacement, and (3) to identify and quantify the inter- and intraobserver agreement. Methods: A prospective clinical measurement study of 22 acute Robinson type 2B1 clavicle fractures was performed. Each patient underwent 8 consecutive standardized and calibrated X-rays in 1 setting. Results: In the upright patient position, the difference of absolute shortening was 4.5 mm (95% confidence interval [CI]: 3.0-5.9, P < .0001) larger than in the supine patient position. For vertical displacement, the odds of being scored a category higher in the upright patient position were 4.7 (95% CI: 2.2-9.8) times as large as the odds of being scored a category higher in supine position. The odds of being scored a category higher on the caudocranial projection were 5.9 (95% CI: 2.8-12.6) times as large as the odds of being scored a category higher on the craniocaudal projection. Conclusion: Absolute shortening, relative shortening, and vertical displacement were found to be the greatest in the upright patient positioning with the arm protracted orientation on a 15° caudocranial projection. No statistically significant differences were found for a change in position of the arm between neutral and protracted. |
| first_indexed | 2024-12-17T07:50:13Z |
| format | Article |
| id | doaj.art-bccef9be23e0418aac585695f065ef6e |
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| issn | 2666-6383 |
| language | English |
| last_indexed | 2024-12-17T07:50:13Z |
| publishDate | 2020-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JSES International |
| spelling | doaj.art-bccef9be23e0418aac585695f065ef6e2022-12-21T21:57:53ZengElsevierJSES International2666-63832020-09-0143503507Influence of radiographic projection and patient positioning on shortening of the fractured claviclePaul Hoogervorst, MD0Arnoud van Geene, MD1Udo Gundlach, MD2Abel Wei, MD3Nico Verdonschot, PhD4Gerjon Hannink, PhD5Department of Orthopaedic Surgery, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands; Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA; Corresponding author: Paul Hoogervorst, MD, Department of Orthopedics, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands.Department of Orthopaedic Surgery, Isala Zwolle, Zwolle, The NetherlandsDepartment of Orthopaedic Surgery, Admiraal De Ruyter Ziekenhuis, Goes, The NetherlandsEmergency Department, Radboud University Medical Center Nijmegen, Nijmegen, The NetherlandsDepartment of Orthopaedic Surgery, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands; Department of Biomechanical Engineering, University of Twente, Enschede, The NetherlandsDepartment of Operating Rooms, Radboud University Medical Center Nijmegen, Nijmegen, The NetherlandsBackground: Radiographic measurements of shortening and vertical displacement in the fractured clavicle are subject to a variety of factors such as patient positioning and projection. The aims of this study were (1) to quantify differences in shortening and vertical displacement in varying patient positions and X-ray projections, (2) to identify the view and patient positioning indicating the largest amount of shortening and vertical displacement, and (3) to identify and quantify the inter- and intraobserver agreement. Methods: A prospective clinical measurement study of 22 acute Robinson type 2B1 clavicle fractures was performed. Each patient underwent 8 consecutive standardized and calibrated X-rays in 1 setting. Results: In the upright patient position, the difference of absolute shortening was 4.5 mm (95% confidence interval [CI]: 3.0-5.9, P < .0001) larger than in the supine patient position. For vertical displacement, the odds of being scored a category higher in the upright patient position were 4.7 (95% CI: 2.2-9.8) times as large as the odds of being scored a category higher in supine position. The odds of being scored a category higher on the caudocranial projection were 5.9 (95% CI: 2.8-12.6) times as large as the odds of being scored a category higher on the craniocaudal projection. Conclusion: Absolute shortening, relative shortening, and vertical displacement were found to be the greatest in the upright patient positioning with the arm protracted orientation on a 15° caudocranial projection. No statistically significant differences were found for a change in position of the arm between neutral and protracted.http://www.sciencedirect.com/science/article/pii/S2666638320300402Claviclefracturesradiological imagingshorteningdisplacementinterrater agreement |
| spellingShingle | Paul Hoogervorst, MD Arnoud van Geene, MD Udo Gundlach, MD Abel Wei, MD Nico Verdonschot, PhD Gerjon Hannink, PhD Influence of radiographic projection and patient positioning on shortening of the fractured clavicle JSES International Clavicle fractures radiological imaging shortening displacement interrater agreement |
| title | Influence of radiographic projection and patient positioning on shortening of the fractured clavicle |
| title_full | Influence of radiographic projection and patient positioning on shortening of the fractured clavicle |
| title_fullStr | Influence of radiographic projection and patient positioning on shortening of the fractured clavicle |
| title_full_unstemmed | Influence of radiographic projection and patient positioning on shortening of the fractured clavicle |
| title_short | Influence of radiographic projection and patient positioning on shortening of the fractured clavicle |
| title_sort | influence of radiographic projection and patient positioning on shortening of the fractured clavicle |
| topic | Clavicle fractures radiological imaging shortening displacement interrater agreement |
| url | http://www.sciencedirect.com/science/article/pii/S2666638320300402 |
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