التفاصيل البيبلوغرافية
| العنوان: |
Factors associated with surgeon recommendation for additional cast immobilization of a CT-verified nondisplaced scaphoid waist fracture |
| المؤلفون: |
Bulstra, Anne Eva J., Crijns, Tom J., Janssen, Stein J., Buijze, Geert A., Ring, David, Jaarsma, Ruurd L., Kerkhoffs, Gino M. M. J., Obdeijn, Miryam C., Doornberg, Job N., Peters, A., Spoor, A. B., Shrivastava, Abhay, Chauhan, Aakash, Shafritz, Adam, Ilyas, Asif M., Vochteloo, Anne J. H., Powell, Andrew John, Castillo, Alberto Pérez, Godoy-Santos, Alexandre Leme, Gelvez, Amparo Gomez, Bauer, Andrea, Barquet, Antonio, Kristan, Anze, Prkic, Ante, Jubel, Axel, Mirck, Boj, Kreis, B. E., Bamberger, H. Brent, Belangero, William Dias, Hearon, Bernard F., Palmer, Bradley, Hyatt, Brad, Wills, Brian P. D., Broekhuyse, Henry, Buckley, Richard, Altintas, Burak, Campbell, Sean T., Ekholm, Carl, Fernandes, Carlos Henrique, Fernandes, C. H., Weiss, Carl, Garnavos, Christos, Metzger, Charles, Wilson, Christopher J., Bainbridge, Chris, Deml, Christian, Moreta, Jesus, Kleweno, Conor, Moreno-Serrano, Constanza L., Ordway, Craig B. |
| المصدر: |
Archives of Orthopaedic and Trauma Surgery ; volume 141, issue 11, page 2011-2018 ; ISSN 0936-8051 1434-3916 |
| بيانات النشر: |
Springer Science and Business Media LLC |
| سنة النشر: |
2021 |
| مصطلحات موضوعية: |
Orthopedics and Sports Medicine, General Medicine, Surgery |
| الوصف: |
Introduction Data from clinical trials suggest that CT-confirmed nondisplaced scaphoid waist fractures heal with less than the conventional 8–12 weeks of immobilization. Barriers to adopting shorter immobilization times in clinical practice may include a strong influence of fracture tenderness and radiographic appearance on decision-making. This study aimed to investigate (1) the degree to which surgeons use fracture tenderness and radiographic appearance of union, among other factors, to decide whether or not to recommend additional cast immobilization after 8 or 12 weeks of immobilization; (2) identify surgeon factors associated with the decision to continue cast immobilization after 8 or 12 weeks. Materials and methods In a survey-based study, 218 surgeons reviewed 16 patient scenarios of CT-confirmed nondisplaced waist fractures treated with cast immobilization for 8 or 12 weeks and recommended for or against additional cast immobilization. Clinical variables included patient sex, age, a description of radiographic fracture consolidation, fracture tenderness and duration of cast immobilization completed (8 versus 12 weeks). To assess the impact of clinical factors on recommendation to continue immobilization we calculated posterior probabilities and determined variable importance using a random forest algorithm. Multilevel logistic mixed regression analysis was used to identify surgeon characteristics associated with recommendation for additional cast immobilization. Results Unclear fracture healing on radiographs, fracture tenderness and 8 (versus 12) weeks of completed cast immobilization were the most important factors influencing surgeons’ decision to recommend continued cast immobilization. Women surgeons (OR 2.96; 95% CI 1.28–6.81, p = 0.011), surgeons not specialized in orthopedic trauma, hand and wrist or shoulder and elbow surgery (categorized as ‘other’) (OR 2.64; 95% CI 1.31–5.33, p = 0.007) and surgeons practicing in the United States (OR 6.53, 95% CI 2.18–19.52, p = 0.01 versus Europe) ... |
| نوع الوثيقة: |
article in journal/newspaper |
| اللغة: |
English |
| DOI: |
10.1007/s00402-021-04062-0 |
| DOI: |
10.1007/s00402-021-04062-0.pdf |
| DOI: |
10.1007/s00402-021-04062-0/fulltext.html |
| الإتاحة: |
https://doi.org/10.1007/s00402-021-04062-0Test |
| حقوق: |
https://creativecommons.org/licenses/by/4.0Test ; https://creativecommons.org/licenses/by/4.0Test |
| رقم الانضمام: |
edsbas.22083FCA |
| قاعدة البيانات: |
BASE |
