Division of Orthopaedic Surgery, Western University, London, ON N6A 5A5, Canada.
Injury. 2020 May;51 Suppl 2:S18-S22. doi: 10.1016/j.injury.2019.12.028. Epub 2020 Jan 11.
The assessment of fracture healing is an imperative and fundamental clinical aspect within orthopaedics. Despite that, there have historically been non-reliable methods utilized to assess for fracture union and nonunion. In recent years, a number of radiographic assessment tools such as the Radiographic Union Score for Tibial fractures (RUST) and Radiographic Union Score for Hip fracture (RUSH) have been developed in order to improve the reliability of fracture assessment for union. These scores have not only increased the reliability of assessments but have also provided thresholds to aid in predicting nonunion as well as union. The nonunion risk determination (NURD) Score was also created to prognosticate these clinical presentations. With the large burdens of cost, lower quality of life and morbidity associated with fracture nonunion, these evaluation methods have provided orthopaedic surgeons with an improved ability to predict nonunion and assist in the management of patients. This review outlines the development, reliability testing as well as biomechanical validity testing associated with these scoring systems.
骨折愈合的评估是矫形外科中必不可少且基本的临床方面。尽管如此，历史上仍有不可靠的方法用于评估骨折愈合和不愈合。近年来，已经开发出许多影像学评估工具，例如胫骨骨折的影像学愈合评分（RUST）和髋部骨折的影像学愈合评分（RUSH），以提高骨折愈合评估的可靠性。这些评分不仅提高了评估的可靠性，而且还提供了阈值来帮助预测不愈合和愈合。还创建了非愈合风险确定（NURD）评分来预测这些临床表现。由于骨折不愈合与成本增加、生活质量下降和发病率增加有关，这些评估方法为矫形外科医生提供了更好的预测不愈合和帮助管理患者的能力。本综述概述了这些评分系统的开发、可靠性测试以及生物力学有效性测试。
