Computed tomography-based diagnosis of occult fragility hip fractures offer shorter waiting times with no inadvertent missed diagnosis.
J Orthop Surg (Hong Kong)
; 28(2): 2309499020932082, 2020.
Article
en En
| MEDLINE
| ID: mdl-32546057
ABSTRACT
PURPOSE:
Surgical delay due to the wait for advanced cross-sectional imaging in occult fragility hip fracture management is not well studied. Our study aims to investigate computed tomography (CT) as an alternative to the gold standard magnetic resonance imaging (MRI) in occult hip fracture workup to decrease surgical delay.METHODS:
We conducted a retrospective review of all CTs and MRIs performed between 2015 and 2017 for patients with clinically suspected fragility hip fractures and negative plain radiographs to investigate surgical delay resulting from the wait for advanced imaging and representations due to missed fractures.RESULTS:
A total of 243 scans (42 CTs and 201 MRIs) were performed for occult hip fracture workup over the study timeframe, of which 49 patients (20%) had occult hip fractures [CT 6 (14%), MRI 43 (21%), p = 0.296)]. There were no readmissions for fracture in the 12 months following a negative scan. The CT group had shorter waiting times (CT 29 ± 24 h, MRI 44 ± 32 h, p = 0.004) without significantly reducing surgical delay (CT 82 ± 36 h, MRI 128 ± 58 h, p = 0.196). The MRI group had a higher number of patients with a cancer history (p = 0.036), reflective of the practice for workup of possible metastases as a secondary intention.CONCLUSION:
Advanced cross-sectional imaging wait times in occult hip fracture workup contribute significantly to surgical delay. Modern CT techniques are not inferior to MRI in detecting occult fractures and may be a suitable alternative in the absence of a cancer history if MRI cannot be obtained in a timely fashion or is contraindicated. Clinicians should utilize the more readily available imaging modality to reduce surgical delay.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Tomografía Computarizada por Rayos X
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Fracturas Osteoporóticas
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Fracturas Cerradas
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Fracturas de Cadera
Tipo de estudio:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
Límite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Orthop Surg (Hong Kong)
Asunto de la revista:
ORTOPEDIA
Año:
2020
Tipo del documento:
Article
País de afiliación:
Singapur