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Application d’une Échelle de consolidation radiographique des fractures du Tibia (ECRFT) : évaluation du taux et du temps de guérison des fractures du tibia traitées par enclouage centromédullaire
Revue de chirurgie orthopédique et traumatologique 106 (2020) 38
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Mémoire original
Application d’une Échelle de consolidation radiographique des fractures du Tibia (ECRFT) : évaluation du taux et du temps de guérison des fractures du tibia traitées par enclouage centromédullaire夽 Application of the radiographic union scale for tibial fractures (RUST): Assessment of healing rate and time of tibial fractures managed with intramedullary nailing Jun Min Leow ∗ , Nicholas D. Clement , A. Hamish W.R. Simpson Department of Orthopaedics and Trauma, The Royal Infirmary of Edinburgh, Little France, EH16 4SA Edinburgh, Royaume-Uni
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a r t i c l e
Historique de l’article : ´ 2017 Rec¸u le 23 decembre Accepté le 7 octobre 2019 Keywords: RUST Non-union Delayed union Fracture union Radiographic assessment
a b s t r a c t Introduction. – Tibial fractures are devastating injuries and a cause of significant morbidity. There is limited information describing the length of time it takes for these injuries to heal. The aim of this study was to define the normal distribution of healing times of a consecutive series of tibial fractures treated with intramedullary (IM) nailing by applying the Radiographic Union Scale for Tibial fractures (RUST). Methods. – Hundred and eighty radiographs from 217 patients were assessed with RUST. Patients requiring more than one standard deviation from the mean were defined to have a delayed union. Results. – Sixteen patients (7%) developed non-unions and 30 patients (14%) had delayed union. Of the 201 patients who achieved union, the mean time to healing was 18.7 (SD 6.9) weeks, with a wide range from 7 to 52 weeks. In the union group, the rate of healing was greatest in the 8- to 12-week period. In contrast, in the delayed union group there was a lower peak rate of change, which was reached at a later time point. Discussion. – Our data indicates that 7% of patients with tibial fractures treated with IM nailing develop non-unions and over 10% of those progressing to union will take longer than 26 weeks. The data on healing rates is important to surgeons and orthopaedic multidisciplinary staff in guiding management. It can also be of help for patients planning their finances and for giving estimates for personal injury claims. Level of evidence. – IV, retrospective cohort study. Crown Copyright © 2019 Published by Elsevier Masson SAS. All rights reserved.
DOI de l’article original : https://doi.org/10.1016/j.otsr.2019.10.010. 夽 Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (sciencedirect.com) en utilisant le DOI ci-dessus. ∗ Corresponding author. Adresse e-mail : [email protected] (J.M. Leow). https://doi.org/10.1016/j.rcot.2019.11.009 ´ ´ 1877-0517/Crown Copyright © 2019 Publie´ par Elsevier Masson SAS. Tous droits reserv es.
Disponible en ligne sur
ScienceDirect www.sciencedirect.com
Mémoire original
Application d’une Échelle de consolidation radiographique des fractures du Tibia (ECRFT) : évaluation du taux et du temps de guérison des fractures du tibia traitées par enclouage centromédullaire夽 Application of the radiographic union scale for tibial fractures (RUST): Assessment of healing rate and time of tibial fractures managed with intramedullary nailing Jun Min Leow ∗ , Nicholas D. Clement , A. Hamish W.R. Simpson Department of Orthopaedics and Trauma, The Royal Infirmary of Edinburgh, Little France, EH16 4SA Edinburgh, Royaume-Uni
i n f o
a r t i c l e
Historique de l’article : ´ 2017 Rec¸u le 23 decembre Accepté le 7 octobre 2019 Keywords: RUST Non-union Delayed union Fracture union Radiographic assessment
a b s t r a c t Introduction. – Tibial fractures are devastating injuries and a cause of significant morbidity. There is limited information describing the length of time it takes for these injuries to heal. The aim of this study was to define the normal distribution of healing times of a consecutive series of tibial fractures treated with intramedullary (IM) nailing by applying the Radiographic Union Scale for Tibial fractures (RUST). Methods. – Hundred and eighty radiographs from 217 patients were assessed with RUST. Patients requiring more than one standard deviation from the mean were defined to have a delayed union. Results. – Sixteen patients (7%) developed non-unions and 30 patients (14%) had delayed union. Of the 201 patients who achieved union, the mean time to healing was 18.7 (SD 6.9) weeks, with a wide range from 7 to 52 weeks. In the union group, the rate of healing was greatest in the 8- to 12-week period. In contrast, in the delayed union group there was a lower peak rate of change, which was reached at a later time point. Discussion. – Our data indicates that 7% of patients with tibial fractures treated with IM nailing develop non-unions and over 10% of those progressing to union will take longer than 26 weeks. The data on healing rates is important to surgeons and orthopaedic multidisciplinary staff in guiding management. It can also be of help for patients planning their finances and for giving estimates for personal injury claims. Level of evidence. – IV, retrospective cohort study. Crown Copyright © 2019 Published by Elsevier Masson SAS. All rights reserved.
DOI de l’article original : https://doi.org/10.1016/j.otsr.2019.10.010. 夽 Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (sciencedirect.com) en utilisant le DOI ci-dessus. ∗ Corresponding author. Adresse e-mail : [email protected] (J.M. Leow). https://doi.org/10.1016/j.rcot.2019.11.009 ´ ´ 1877-0517/Crown Copyright © 2019 Publie´ par Elsevier Masson SAS. Tous droits reserv es.