Department of Orthopaedics and Traumatology of Locomotor System, Centre of Excellence "TeleOrto," Medical University of Warsaw, Warsaw, Poland.
Telemed J E Health. 2011 Apr;17(3):201-10. doi: 10.1089/tmj.2010.0131. Epub 2011 Mar 10.
The lack of a universal system for fracture healing progress evaluation recommended by evidence-based orthopedics is mentioned in current literature. Radiographs and the observation of clinical signs and symptoms remain standard practice for the assessment of fracture healing progress.
The general aim of this study was to show the main functionalities of the Web-based telediagnostic tools designed to improve fracture healing assessment follow-up and to present a study of fracture healing assessment based on collected study group of long bone fracture cases.
The originally designed Web-based system was used to assess remotely fracture healing in 40 complete radiographic sets (211 radiographs) randomly selected from a database. Digital radiographic images and clinical data were stored in the database and then subjected to detailed analysis. Descriptive classifications, scorings, and radiographic image optical density analysis measurements were used for a series of cases.
Curves on the graph, drawn from the consecutive follow-up measurements of fracture gap optical density, can slope down regularly in normal healing cases or remain irregular and disorganized in delayed unions. An association between optical density values, callus index, and descriptive scoring variables was found for normal healing based on results received from Web-based telediagnostic system.
The development of Web-based telediagnostic applications have the potential to improve fracture qualitative and quantitative evaluation and monitoring for the improvement of the quality of fracture care. The results imply the feasibility of Web-based fracture healing assessment telediagnostic applications over the Internet.
目前的文献中提到，缺乏循证骨科推荐的通用骨折愈合评估系统。放射照片和临床体征与症状的观察仍然是评估骨折愈合进展的标准做法。
本研究的总体目的是展示为改进骨折愈合评估随访而设计的基于网络的远程诊断工具的主要功能，并介绍一项基于收集的长骨骨折病例研究组的骨折愈合评估研究。
最初设计的基于网络的系统用于远程评估 40 个完整放射学套件（211 张放射照片）中的骨折愈合情况，这些套件是从数据库中随机选择的。数字放射图像和临床数据存储在数据库中，然后进行详细分析。对一系列病例进行描述性分类、评分和放射图像光密度分析测量。
从骨折间隙光密度的连续随访测量得出的图表曲线在正常愈合的情况下可以规则地下行，而在延迟愈合的情况下则保持不规则和混乱。基于从基于网络的远程诊断系统获得的结果，发现正常愈合的光密度值、骨痂指数和描述性评分变量之间存在关联。
基于网络的远程诊断应用程序的开发有可能改善骨折的定性和定量评估和监测，从而提高骨折护理的质量。结果表明，通过互联网进行基于网络的骨折愈合评估远程诊断应用是可行的。
