Interdisciplinary consensus statements on imaging of scaphoid fractures.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Dietrich Tobias Johannes, Teh James, Schmitt Rainer, Blum Alain, Hesse Nina, Lalam Radhesh Krishna, Toms Andoni Paul, Becce Fabio, Omoumi Patrick, Shahabpour Maryam, Bień Maciej, Zanetti Marco, Boutin Robert Downey, Fritz Jan, Llopis Eva, Bazzocchi Alberto, Afonso P Diana, Mascarenhas Vasco V, Sutter Reto, Cotten Anne, Drapé Jean-Luc, Bierry Guillaume, Pracoń Grzegorz, de Jonge Milko C, Dalili Danoob, Mespreuve Marc, Klich Maciej, Nagy Ladislav, Szabo Robert M, Grünert Jörg G, Camus Emmanuel J, Bain Gregory Ian, Mathoulin Christophe L, Goehtz Florian, Garcia-Elias Marc, Van Overstraeten Luc, Del Piñal Francisco, Atzei Andrea, Luchetti Riccardo, Chojnowski Adrian Julian, Czarnecki Piotr, Corella Fernando, Yamamoto Michiro, Golubev Igor O, van Schoonhoven Jörg, Cerezal Luis, Sudoł-Szopińska Iwona
Аннотация
MATERIALS AND METHODS: Nineteen hand surgeons formulated a preliminary list of eleven questions on imaging of scaphoid fractures. Based on this preliminary list, radiologists crafted statements considering literature and their clinical experience, then refined them through an iterative Delphi process to revise the questions and statements. A maximum of three Delphi rounds was scheduled until group consensus was achieved for an individual statement, whichever arose first. Twenty-eight radiologists drafted the statements and acted as Delphi panellists. Panellists rated their level of agreement with each statement on an 11-point numeric rating scale, the score '0' indicated complete disagreement and the score '10' indicated complete agreement, respectively. Group consensus was specified as a score of '8' or higher for ≥ 23/28 panellists.
RESULTS: Eight of eleven questions and statements achieved group consensus in the first Delphi round. The remaining three questions and statements achieved group consensus in the second Delphi round, indicating more controversial topics. It was agreed that radiographs are the initial imaging technique of choice for suspected scaphoid fractures. MRI or CT are advocated for suspected radiographically occult scaphoid fractures. CT is the method of choice for assessment of osseous consolidation. Contrast-enhanced MRI is the preferred imaging modality for assessing vascularisation of scaphoid nonunion. CT is the most valuable technique in the postoperative evaluation of scaphoid fractures.
CONCLUSION: Delphi-based consensus statements suggest imaging pathways to diagnose scaphoid fractures, assess osseous fracture consolidation and evaluate pre- and postoperative fractures.
KEY POINTS: Question How can an international and interdisciplinary team of hand surgeons and musculoskeletal radiologists develop practical consensus statements on imaging of scaphoid fractures? Findings All eleven statements achieved group consensus among experts using the Delphi technique for consensus-building. Imaging pathways were suggested to diagnose and assess scaphoid fractures. Clinical relevance statement International, interdisciplinary and evidence-based consensus statements on imaging of scaphoid fractures were achieved using the Delphi technique. The focus of the statements was to diagnose scaphoid fractures, assess osseous fracture consolidation and evaluate pre- and postoperative fractures.