Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Salaya, Thailand.
Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Salaya, Thailand.
PLoS One. 2024 Mar 15;19(3):e0300014. doi: 10.1371/journal.pone.0300014. eCollection 2024.
Although lateral humeral condyle fracture is common, the incidence of missed diagnosis is very high. Delayed and missed diagnosis led to significant morbidities and loss of functions. We designed a pediatric elbow radiographic guidance aiming to improve the accuracy of diagnosis. This study was aimed to evaluate the efficacy of the radiographic guidance for the diagnosis of lateral condyle fracture. A cross-sectional study was conducted after defining the essential parameters as a guidance for assessing the pediatric elbow radiographs. We included medical students, emergency medicine, orthopedic, and radiology residents and fellows into this study. A questionnaire was used to evaluate the efficacy of the guidance. All participants underwent a pretest evaluation, followed by studying the guidance, and then finished a posttest evaluation. Baseline characteristics, diagnostic scores, and parameter evaluation scores were collected. The pretest and posttest scores were analyzed using paired t-test. Association between baseline characteristics and diagnostic scores were analyzed using multiple regression analysis. We included 177 participants. Average diagnostic score was significantly increased after using the guidance, from 12.2 ± 1.9 to 13.0 ± 1.7 (p < 0.0001). Medical students showed the most improvement, from 11.9 ± 1.9 to 13.1 ± 1.3 (p <0.001). All means of essential parameter evaluation scores were significantly improved in overall participants.The pediatric elbow radiographic guidance is useful for evaluation and diagnosis of lateral condyle fracture, especially for young physicians and trainees. Therefore, this should be recommended in routine medical education and general practice.
虽然肱骨外髁骨折很常见,但漏诊率非常高。延迟和漏诊导致了显著的发病率和功能丧失。我们设计了一种儿科肘部 X 线摄影引导系统,旨在提高诊断的准确性。本研究旨在评估该 X 线摄影引导系统对诊断外侧髁骨折的疗效。在定义了评估儿科肘部 X 线片的基本参数后,进行了一项横断面研究。我们将医学生、急诊医学、骨科和放射科住院医师和研究员纳入了这项研究。使用问卷调查评估了该引导的效果。所有参与者都接受了预测试评估,然后学习了该引导,最后进行了后测试评估。收集了基线特征、诊断评分和参数评估评分。使用配对 t 检验分析了预测试和后测试评分。使用多元回归分析了基线特征和诊断评分之间的关系。我们共纳入了 177 名参与者。使用该引导后,平均诊断评分显著提高,从 12.2 ± 1.9 提高到 13.0 ± 1.7(p < 0.0001)。医学生的提高最为显著,从 11.9 ± 1.9 提高到 13.1 ± 1.3(p < 0.001)。所有基本参数评估评分的平均值在所有参与者中都显著提高。儿科肘部 X 线摄影引导系统对于评估和诊断外侧髁骨折是有用的,特别是对于年轻医生和受训者。因此,应该在常规医学教育和常规实践中推荐使用该方法。