There is a need to come up with low-cost strategies for assessing fracture union following surgical treatment in developing countries. We aimed to develop one by determining the optimal surveillance schedule taking into account associated factors and the diagnostic performance of the Squat & Smile (S & S) test. A total of 80 patients with lower extremity fracture treated with the SIGN nail were followed for at least 8 months. Time to fracture union was calculated using the Radiographic Union Scale in Tibial Fractures (RUST) scoring and variables were analyzed for association with fracture union. Forty-eight patients performed additional S & S test. Sensitivity, specificity, positive and negative predictive values, and the diagnostic accuracy of S & S test were assessed. Ten (12.5%) of 80 patients developed nonunion, and the presence of superficial infection (28.5 ± 5.6 weeks vs 17.2 ± 1.2 weeks, p=.01) and pain on weight-bearing (29.6 ± 2.2 weeks vs 16.8 ± 1.2 weeks, p < .001) were associated factors. Cumulative incidence at 16 weeks was 59% (58% to 60%). The S & S test had high Sn (90%) and Sp (100%) in diagnosing union. The NPV and PPV were 67% and 100%, respectively, with a diagnostic accuracy of 92%. We concluded that S & S test may reliably detect fracture union by fourth month after surgery, while closer follow-up is likely needed for patients developing superficial infection or pain on weight-bearing.
| Published in | Journal of Surgery (Volume 10, Issue 3) |
| DOI | 10.11648/j.js.20221003.14 |
| Page(s) | 111-116 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
RUST, Squat and Smile Test, SIGN, Trauma, Fracture
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APA Style
Erika Paulina Stefani See, Mamer Rosario. (2022). Low-Cost Surveillance for Lower Extremity Fracture Union After Intramedullary Nailing – Experience on 80 Sign Patients by a Philippine Trauma Center. Journal of Surgery, 10(3), 111-116. https://doi.org/10.11648/j.js.20221003.14
ACS Style
Erika Paulina Stefani See; Mamer Rosario. Low-Cost Surveillance for Lower Extremity Fracture Union After Intramedullary Nailing – Experience on 80 Sign Patients by a Philippine Trauma Center. J. Surg. 2022, 10(3), 111-116. doi: 10.11648/j.js.20221003.14
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Download@article{10.11648/j.js.20221003.14,
author = {Erika Paulina Stefani See and Mamer Rosario},
title = {Low-Cost Surveillance for Lower Extremity Fracture Union After Intramedullary Nailing – Experience on 80 Sign Patients by a Philippine Trauma Center},
journal = {Journal of Surgery},
volume = {10},
number = {3},
pages = {111-116},
doi = {10.11648/j.js.20221003.14},
url = {https://doi.org/10.11648/j.js.20221003.14},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20221003.14},
abstract = {There is a need to come up with low-cost strategies for assessing fracture union following surgical treatment in developing countries. We aimed to develop one by determining the optimal surveillance schedule taking into account associated factors and the diagnostic performance of the Squat & Smile (S & S) test. A total of 80 patients with lower extremity fracture treated with the SIGN nail were followed for at least 8 months. Time to fracture union was calculated using the Radiographic Union Scale in Tibial Fractures (RUST) scoring and variables were analyzed for association with fracture union. Forty-eight patients performed additional S & S test. Sensitivity, specificity, positive and negative predictive values, and the diagnostic accuracy of S & S test were assessed. Ten (12.5%) of 80 patients developed nonunion, and the presence of superficial infection (28.5 ± 5.6 weeks vs 17.2 ± 1.2 weeks, p=.01) and pain on weight-bearing (29.6 ± 2.2 weeks vs 16.8 ± 1.2 weeks, p < .001) were associated factors. Cumulative incidence at 16 weeks was 59% (58% to 60%). The S & S test had high Sn (90%) and Sp (100%) in diagnosing union. The NPV and PPV were 67% and 100%, respectively, with a diagnostic accuracy of 92%. We concluded that S & S test may reliably detect fracture union by fourth month after surgery, while closer follow-up is likely needed for patients developing superficial infection or pain on weight-bearing.},
year = {2022}
}
TY - JOUR T1 - Low-Cost Surveillance for Lower Extremity Fracture Union After Intramedullary Nailing – Experience on 80 Sign Patients by a Philippine Trauma Center AU - Erika Paulina Stefani See AU - Mamer Rosario Y1 - 2022/05/24 PY - 2022 N1 - https://doi.org/10.11648/j.js.20221003.14 DO - 10.11648/j.js.20221003.14 T2 - Journal of Surgery JF - Journal of Surgery JO - Journal of Surgery SP - 111 EP - 116 PB - Science Publishing Group SN - 2330-0930 UR - https://doi.org/10.11648/j.js.20221003.14 AB - There is a need to come up with low-cost strategies for assessing fracture union following surgical treatment in developing countries. We aimed to develop one by determining the optimal surveillance schedule taking into account associated factors and the diagnostic performance of the Squat & Smile (S & S) test. A total of 80 patients with lower extremity fracture treated with the SIGN nail were followed for at least 8 months. Time to fracture union was calculated using the Radiographic Union Scale in Tibial Fractures (RUST) scoring and variables were analyzed for association with fracture union. Forty-eight patients performed additional S & S test. Sensitivity, specificity, positive and negative predictive values, and the diagnostic accuracy of S & S test were assessed. Ten (12.5%) of 80 patients developed nonunion, and the presence of superficial infection (28.5 ± 5.6 weeks vs 17.2 ± 1.2 weeks, p=.01) and pain on weight-bearing (29.6 ± 2.2 weeks vs 16.8 ± 1.2 weeks, p < .001) were associated factors. Cumulative incidence at 16 weeks was 59% (58% to 60%). The S & S test had high Sn (90%) and Sp (100%) in diagnosing union. The NPV and PPV were 67% and 100%, respectively, with a diagnostic accuracy of 92%. We concluded that S & S test may reliably detect fracture union by fourth month after surgery, while closer follow-up is likely needed for patients developing superficial infection or pain on weight-bearing. VL - 10 IS - 3 ER -
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