Abstract
Objective: This study aimed to define the role of the lateral X-ray in the assessment and treatment planning of proximal femoral fractures. Occult fractures were not included. Methods: Radiographs from 359 consecutive patients with proximal femoral fractures admitted to our emergency department over a 12month period were divided into anteroposterior (AP) views and lateral views. Three blinded reviewers independently assessed the radiographs, first AP views alone then AP plus lateral views, noting the fracture classification for each radiograph. These assessments were then compared with the intra-operative diagnosis, which was used as the gold standard. A 2 x 2 contingency square table was created and Pearson's χ2 test was used for statistical analysis. Results: The rate of correct classification by the reviewers was improved by the assessment of the lateral X-ray in addition to the AP view for intracapsular fractures (p<0.013) but not for extracapsular fractures (p=0.27). However, the only advantage obtained by assessing the lateral view in intracapsular fractures was the detection of displacement where the fracture appeared undisplaced on the initial AP view. Conclusion: This study provides statistical evidence that one view is adequate and safe for the majority of hip fractures. The lateral radiograph should not be performed routinely in order to make considerable savings in money and time and to avoid unnecessary patient discomfort.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 413-417 |
| Number of pages | 5 |
| Journal | British Journal of Radiology |
| Volume | 84 |
| Issue number | 1001 |
| DOIs | |
| State | Published - May 2011 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
Cite this
Another fractured neck of femur : Do we need a lateral X-ray? / Almazedi, Bahir; Smith, C. D.; Morgan, D.; Thomas, G.; Pereira, Gavin Caesar.
In: British Journal of Radiology, Vol. 84, No. 1001, 05.2011, p. 413-417.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Another fractured neck of femur
T2 - Do we need a lateral X-ray?
AU - Almazedi, Bahir
AU - Smith, C. D.
AU - Morgan, D.
AU - Thomas, G.
AU - Pereira, Gavin Caesar
PY - 2011/5
Y1 - 2011/5
N2 - Objective: This study aimed to define the role of the lateral X-ray in the assessment and treatment planning of proximal femoral fractures. Occult fractures were not included. Methods: Radiographs from 359 consecutive patients with proximal femoral fractures admitted to our emergency department over a 12month period were divided into anteroposterior (AP) views and lateral views. Three blinded reviewers independently assessed the radiographs, first AP views alone then AP plus lateral views, noting the fracture classification for each radiograph. These assessments were then compared with the intra-operative diagnosis, which was used as the gold standard. A 2 x 2 contingency square table was created and Pearson's χ2 test was used for statistical analysis. Results: The rate of correct classification by the reviewers was improved by the assessment of the lateral X-ray in addition to the AP view for intracapsular fractures (p<0.013) but not for extracapsular fractures (p=0.27). However, the only advantage obtained by assessing the lateral view in intracapsular fractures was the detection of displacement where the fracture appeared undisplaced on the initial AP view. Conclusion: This study provides statistical evidence that one view is adequate and safe for the majority of hip fractures. The lateral radiograph should not be performed routinely in order to make considerable savings in money and time and to avoid unnecessary patient discomfort.
AB - Objective: This study aimed to define the role of the lateral X-ray in the assessment and treatment planning of proximal femoral fractures. Occult fractures were not included. Methods: Radiographs from 359 consecutive patients with proximal femoral fractures admitted to our emergency department over a 12month period were divided into anteroposterior (AP) views and lateral views. Three blinded reviewers independently assessed the radiographs, first AP views alone then AP plus lateral views, noting the fracture classification for each radiograph. These assessments were then compared with the intra-operative diagnosis, which was used as the gold standard. A 2 x 2 contingency square table was created and Pearson's χ2 test was used for statistical analysis. Results: The rate of correct classification by the reviewers was improved by the assessment of the lateral X-ray in addition to the AP view for intracapsular fractures (p<0.013) but not for extracapsular fractures (p=0.27). However, the only advantage obtained by assessing the lateral view in intracapsular fractures was the detection of displacement where the fracture appeared undisplaced on the initial AP view. Conclusion: This study provides statistical evidence that one view is adequate and safe for the majority of hip fractures. The lateral radiograph should not be performed routinely in order to make considerable savings in money and time and to avoid unnecessary patient discomfort.
UR - http://www.scopus.com/inward/record.url?scp=79955097140&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79955097140&partnerID=8YFLogxK
U2 - 10.1259/bjr/57316056
DO - 10.1259/bjr/57316056
M3 - Article
C2 - 21081578
AN - SCOPUS:79955097140
VL - 84
SP - 413
EP - 417
JO - British Journal of Radiology
JF - British Journal of Radiology
SN - 0007-1285
IS - 1001
ER -