BACKGROUND: Interobserver reliability for the classification of proximal humeral fractures is limited. The aim of this study was to test the null hypothesis that interobserver reliability of the AO classification of proximal humeral fractures, the preferred treatment, and fracture characteristics is the same for two-dimensional (2-D) and three-dimensional (3-D) computed tomography (CT).

METHODS: Members of the Science of Variation Group--fully trained practicing orthopaedic and trauma ...

PURPOSE: This study tested the null hypothesis that there are no differences between the preferences of hand surgeons and those patients with carpal tunnel syndrome (CTS) facing decisions about management of CTS (ie, the preferred content of a decision aid).

METHODS: One hundred three hand surgeons of the Science of Variation Group and 79 patients with CTS completed a survey about their priorities and preferences in decision making regarding the management of CTS. The questionnaire was ...

BACKGROUND: Recent work has established that apparently isolated fractures of the capitellum are often more complex and involve the lateral epicondyle, trochlea, and posterior aspect of the distal part of the humerus. We assessed the experience with operative stabilization of fractures of the capitellum and trochlea at one level-I trauma center over a twenty-eight-year period.

METHODS: Thirty classifiable partial articular fractures involving the capitellum and trochlea were included in ...

PURPOSE: We investigated the hypothesis that a quantitative 3-dimensional computed tomography (Q3DCT) modeling technique based on anatomical and demographic data that can measure size, shape, and proximal articular surface area can be used to develop formulas that could predict the volume and proximal surface area of the intact radial head in patients with fractures of the radial head.

METHODS: We used a consecutive series of 50 computed tomography scans with a slice thickness of 1.25 mm ...

PURPOSE: To identify risk factors for complications after volar locking plate fixation of distal radius fractures.

METHODS: We assessed early postoperative complications in 594 patients with fracture of the distal radius repaired with a volar locking plate and a minimum 1-month evaluation in the medical record. Later complications were assessed among 321 patients as a subset of the original cohort with a minimum 6 months' evaluation. We compared patient demographics, fracture ...

BACKGROUND: For greater tuberosity fractures, 5-mm displacement is a commonly used threshold for recommending surgery; however, it is unclear if displacement can be assessed with this degree of precision and reliability using plain radiographs. It also is unclear if CT images provide additional information that might change decision making.

QUESTION/PURPOSES: We asked: (1) Does interobserver agreement for assessment of the amount and direction of fracture-fragment displacement vary based ...

PURPOSE: To determine the interobserver agreement and diagnostic performance characteristics of computed tomography (CT) for determining union of scaphoid waist fractures.

METHODS: A total of 59 orthopedic and trauma surgeons rated for union a set of 30 sagittal CT scans of 30 scaphoid waist fractures. Of these fractures, 20 were treated nonoperatively, were imaged between 6 and 10 weeks after injury, and were known to have eventually achieved union. Ten were operatively confirmed to be ...

BACKGROUND: The Broberg and Morrey modification of the Mason classification of radial head fractures has substantial interobserver variation. This study used a large web-based collaborative of experienced orthopaedic surgeons to test the hypothesis that three-dimensional reconstructions of computed tomography (CT) scans improve the interobserver reliability of the classification of radial head fractures according to the Broberg and Morrey modification of the Mason ...

BACKGROUND: The most common location of a displaced fracture of part of the radial head is often described as the anterior lateral aspect of the radial head with the forearm in neutral position, based on observation rather than precise measurements. The purpose of our study was to measure the exact location of fractures involving part of the radial head using quantitative 3-dimensional computed tomography (CT).

MATERIALS AND METHODS: We measured the fracture lines with respect to the ...

BACKGROUND: The diagnosis of displacement in scaphoid fractures is notorious for poor interobserver reliability.

QUESTIONS/PURPOSES: We tested whether training can improve interobserver reliability and sensitivity, specificity, and accuracy for the diagnosis of scaphoid fracture displacement on radiographs and CT scans.

METHODS: Sixty-four orthopaedic surgeons rated a set of radiographs and CT scans of 10 displaced and 10 nondisplaced scaphoid fractures for the presence of displacement, ...

PURPOSE: Using quantitative 3-dimensional computed tomography (Q3DCT) modeling, we tested the null hypothesis that there was no difference in fracture fragment volume, articular surface involvement, and number of fracture fragments between coronoid fracture types and patterns of traumatic elbow instability.

METHODS: We studied 82 patients with a computed tomography scan of a coronoid fracture using Q3DCT modeling. Fracture fragments were identified and fragment volume and articular ...

HYPOTHESIS: Among radial head fractures displaced greater than 2 mm (Broberg and Morrey modified Mason type 2), separation (complete loss of cortical contact) of at least 1 radial head fracture fragment is associated with a complex injury pattern, meaning that there are other concomitant elbow fractures or ligament injuries.

MATERIALS AND METHODS: We identified 291 consecutive skeletally mature patients with 296 radial head fractures treated during a 6-year period. Of these, 121 ...

INTRODUCTION: Six week follow-up radiographs are a common reference standard for the diagnosis of suspected scaphoid fractures. The main purpose of this study was to evaluate the interobserver reliability and diagnostic performance characteristics of 6-weeks radiographs for the detection of scaphoid fractures. In addition, two online techniques for evaluating radiographs were compared.

MATERIALS AND METHODS: A total of 81 orthopedic surgeons affiliated with the Science of Variation Group ...

BACKGROUND: Studies of traumatic elbow instability suggest that recognition of a pattern in the combination and character of the fractures and joint displacements helps predict soft tissue injury and guide the treatment of traumatic elbow instability, but there is no evidence that patterns can be identified reliably.

QUESTIONS/PURPOSES: We therefore determined (1) the interobserver reliability of identifying specific patterns of traumatic elbow instability on radiographs for subgroups of ...

BACKGROUND: Operative treatment of a displaced, transverse, noncomminuted fracture of the olecranon is associated with good to excellent elbow function in retrospective short-term followup studies. However, to our knowledge, no studies have evaluated objective and subjective outcomes using standardized outcome instruments (ie, DASH and Mayo Elbow Performance Index [MEPI]) to quantify long-term outcome of these specific fractures.

QUESTIONS/PURPOSES: We evaluated (1) factors associated ...