DO TRACTION-INTERNAL ROTATION X-RAYS HAVE AN AFFECT ON THE TREATMENT OPTIONS OF PROXIMAL FEMUR FRACTURES AMONG ORTHOPEDIC SURGEONS WITH DIFFERENT LEVELS OF EXPERTISE?

Emre Kocazeybek; Taha Furkan Yağcı; Mehmet Demirel; Yavuz Sağlam; Cengiz Şen

Makale detayları

DO TRACTION-INTERNAL ROTATION X-RAYS HAVE AN AFFECT ON THE TREATMENT OPTIONS OF PROXIMAL FEMUR FRACTURES AMONG ORTHOPEDIC SURGEONS WITH DIFFERENT LEVELS OF EXPERTISE?

Yazarlar:

Emre Kocazeybek | Taha Furkan Yağcı | Mehmet Demirel | Yavuz Sağlam | Cengiz Şen

Yayıncı:

Istanbul University

Ana Başlıklar:

Sağlık Hizmetleri ve Sistemleri (Diğer)

Dergi:

İstanbul Tıp Fakültesi Dergisi Vol.88 Issue 2, pp.102-107

Belge Tipi:

Makale

Yayın Tarihi:

4/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001349267

pISSN:

1305-6441

Anahtar kelimeler:

Özet:

 Objective: The purpose of the current study was to investigate whether the traction-internal rotation X-ray used in proximal femur fractures actually alters the implant choice among 12 different levels of expertise orthopaedic surgeons. Material and Methods: The radiographs of 50 patients who were treated due to proximal femur fracture in our clinic were identified retrospectively. Twelve orthopaedic surgeons evaluated the patient X-rays in two different rounds, two weeks apart. Each observer was asked to independently examine the anteroposterior radiographs of both hips in the first round and the traction-internal rotation radiographs in the second round. Inter-observer agreement was determined using the Fleiss Kappa statistic, while intra-observer agreement was calculated using the Kappa statistic. Results: A total of 50 patients with proximal femur fractures were included in our study. 26 of the patients were female 52 and 24 48 were male. The average age of the participants was 70 5094. The implant options were as follows: total hip arthroplasty, hemiarthroplasty, proximal femur nail, long femur nail, 95 AO blade plate, anatomical plate, cannulated screw and dynamic hip screw. The intraobserver agreement was found to be moderate to substantial κ0.44-0.68 in consultant trauma surgeons, moderate in senior orthopaedic surgeons κ0.47-0.56 and fair to moderate κ0.24-0.59 in orthopaedic residents. The inter-observer agreement was moderate to substantial between consultant trauma surgeons κ0.56-0.62, moderate agreement between senior orthopaedic surgeons and fair agreement between orthopaedic residents respectively κ0.45, κ0.30. Conclusion: Traction radiography is crucial in the proper classification of proximal femur fractures in accordance with the literature. This study shows that as professional experience increases, traction radiography increases the consistency in surgical implant selection.

 Objective: The purpose of the current study was to investigate whether the traction-internal rotation X-ray used in proximal femur fractures actually alters the implant choice among 12 different levels of expertise orthopaedic surgeons. Material and Methods: The radiographs of 50 patients who were treated due to proximal femur fracture in our clinic were identified retrospectively. Twelve orthopaedic surgeons evaluated the patient X-rays in two different rounds, two weeks apart. Each observer was asked to independently examine the anteroposterior radiographs of both hips in the first round and the traction-internal rotation radiographs in the second round. Inter-observer agreement was determined using the Fleiss Kappa statistic, while intra-observer agreement was calculated using the Kappa statistic. Results: A total of 50 patients with proximal femur fractures were included in our study. 26 of the patients were female 52 and 24 48 were male. The average age of the participants was 70 5094. The implant options were as follows: total hip arthroplasty, hemiarthroplasty, proximal femur nail, long femur nail, 95 AO blade plate, anatomical plate, cannulated screw and dynamic hip screw. The intraobserver agreement was found to be moderate to substantial κ0.44-0.68 in consultant trauma surgeons, moderate in senior orthopaedic surgeons κ0.47-0.56 and fair to moderate κ0.24-0.59 in orthopaedic residents. The inter-observer agreement was moderate to substantial between consultant trauma surgeons κ0.56-0.62, moderate agreement between senior orthopaedic surgeons and fair agreement between orthopaedic residents respectively κ0.45, κ0.30. Conclusion: Traction radiography is crucial in the proper classification of proximal femur fractures in accordance with the literature. This study shows that as professional experience increases, traction radiography increases the consistency in surgical implant selection.

 Objective: The purpose of the current study was to investigate whether the traction-internal rotation X-ray used in proximal femur fractures actually alters the implant choice among 12 different levels of expertise orthopaedic surgeons. Material and Methods: The radiographs of 50 patients who were treated due to proximal femur fracture in our clinic were identified retrospectively. Twelve orthopaedic surgeons evaluated the patient X-rays in two different rounds, two weeks apart. Each observer was asked to independently examine the anteroposterior radiographs of both hips in the first round and the traction-internal rotation radiographs in the second round. Inter-observer agreement was determined using the Fleiss Kappa statistic, while intra-observer agreement was calculated using the Kappa statistic. Results: A total of 50 patients with proximal femur fractures were included in our study. 26 of the patients were female 52 and 24 48 were male. The average age of the participants was 70 5094. The implant options were as follows: total hip arthroplasty, hemiarthroplasty, proximal femur nail, long femur nail, 95 AO blade plate, anatomical plate, cannulated screw and dynamic hip screw. The intraobserver agreement was found to be moderate to substantial κ0.44-0.68 in consultant trauma surgeons, moderate in senior orthopaedic surgeons κ0.47-0.56 and fair to moderate κ0.24-0.59 in orthopaedic residents. The inter-observer agreement was moderate to substantial between consultant trauma surgeons κ0.56-0.62, moderate agreement between senior orthopaedic surgeons and fair agreement between orthopaedic residents respectively κ0.45, κ0.30. Conclusion: Traction radiography is crucial in the proper classification of proximal femur fractures in accordance with the literature. This study shows that as professional experience increases, traction radiography increases the consistency in surgical implant selection.

 Amaç: Bu çalışmanın amacı, proksimal femur kırıklarında kullanılan traksiyon-iç rotasyon röntgeninin, 12 farklı uzmanlık seviyesindeki ortopedik cerrahlar arasında implant seçimini gerçekten değiştirip değiştirmediğini araştırmaktır. Gereç ve Yöntem: Kliniğimizde proksimal femur kırığı nedeniyle tedavi edilen 50 hastanın radyografileri retrospektif olarak belirlendi. Hasta röntgenleri 12 ortopedik cerrah tarafından iki hafta arayla iki farklı turda değerlendirildi. İlk turda her gözlemciden her iki kalçanın ön-arka radyografilerini, ikinci turda ise traksiyon-iç rotasyon radyografilerini bağımsız olarak incelemeleri istendi. Gözlemciler arası uyum için Fleiss Kappa istatistiği, gözlemciler içi uyum için Cohen Kappa kat sayısı kullanıldı. Bulgular: Çalışmamıza proksimal femur kırığı olan toplam 50 hasta dahil edildi. Hastaların 26sı 52 kadın, 24ü 48 erkekti. Katılımcıların yaş ortalaması 70 5094 idi. İmplant seçenekleri total kalça artroplastisi, hemiartroplasti, proksimal femur çivisi, uzun femur çivisi, 95 AO blade plak, anatomik plak, kanüllü vida ve dinamik kalça vidası olarak belirlendi. Gözlemciler içi uyum danışman travma cerrahlarında orta ila önemli κ0,44-0,68, kıdemli ortopedi cerrahlarında orta κ0,47-0,56 ve ortopedi asistanlarında ortanın altı ve orta κ0,24-0,59 olarak saptandı. Gözlemciler arasında uyum ise danışman travma cerrahları arasında orta ila önemli düzeyde κ0,56-0,62, kıdemli ortopedi cerrahlar arasında orta derecede ve ortopedi asistanları arasında ortanın altı düzeyde κ0,45, κ0,30 idi. Sonuç: Traksiyon radyografisi proksimal femur kırıklarının literatüre uygun olarak doğru sınıflandırılmasında önemlidir. Bu çalışma mesleki deneyim arttıkça traksiyon radyografisinin cerrahi implant seçiminde tutarlılığı arttırdığını göstermektedir.

Makale detayları

DO TRACTION-INTERNAL ROTATION X-RAYS HAVE AN AFFECT ON THE TREATMENT OPTIONS OF PROXIMAL FEMUR FRACTURES AMONG ORTHOPEDIC SURGEONS WITH DIFFERENT LEVELS OF EXPERTISE?

Yazarlar:

Emre Kocazeybek | Taha Furkan Yağcı | Mehmet Demirel | Yavuz Sağlam | Cengiz Şen

Yayıncı:

Istanbul University

Ana Başlıklar:

Sağlık Hizmetleri ve Sistemleri (Diğer)

Dergi:

İstanbul Tıp Fakültesi Dergisi Vol.88 Issue 2, pp.102-107

Belge Tipi:

Makale

Yayın Tarihi:

4/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001349267

pISSN:

1305-6441

Hip fracture

traction-internal rotation X-ray

proximal femurKalça kırığı

traksiyon-iç rotasyon röntgeni

proksimal femur

Sayı

Makale detayları

DO TRACTION-INTERNAL ROTATION X-RAYS HAVE AN AFFECT ON THE TREATMENT OPTIONS OF PROXIMAL FEMUR FRACTURES AMONG ORTHOPEDIC SURGEONS WITH DIFFERENT LEVELS OF EXPERTISE?

Yazarlar: Emre Kocazeybek | Taha Furkan Yağcı | Mehmet Demirel | Yavuz Sağlam | Cengiz Şen

Yayıncı: Istanbul University

Ana Başlıklar: Sağlık Hizmetleri ve Sistemleri (Diğer)

Dergi: İstanbul Tıp Fakültesi Dergisi Vol.88 Issue 2, pp.102-107

Belge Tipi: Makale

Yayın Tarihi: 4/2025

Belge Dili: İngilizce

Document ID (Org No.): 2001349267

pISSN: 1305-6441

Hip fracture

traction-internal rotation X-ray

proximal femurKalça kırığı

traksiyon-iç rotasyon röntgeni

proksimal femur

Sayı

Yazarlar:

Emre Kocazeybek | Taha Furkan Yağcı | Mehmet Demirel | Yavuz Sağlam | Cengiz Şen

Yayıncı:

Istanbul University

Ana Başlıklar:

Sağlık Hizmetleri ve Sistemleri (Diğer)

Dergi:

İstanbul Tıp Fakültesi Dergisi Vol.88 Issue 2, pp.102-107

Belge Tipi:

Makale

Yayın Tarihi:

4/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001349267

pISSN:

1305-6441