Abstract
Objective:To test the external validity of the fracture to plafond (FTP - length of fracture/distance to plafond) ratio to rule out distal intra-articular fractures (DIA) in distal tibial shaft fractures at an independent tertiary trauma center.Design:Retrospective cohort study.Setting:Two Level 1 trauma centers.Patients:Two hundred seventeen patients with a distal tibial shaft fracture in the model cohort and 146 patients in the validation cohort.Intervention:Radiographic measurements to calculate FTP ratio.Main Outcome Measurements:Calibration plots, area under receiver operating characteristic curve (AUC), and decision curve analyses to evaluate the external validity of FTP ratio to determine DIA.Results:The AUC for the anteroposterior (AP) FTP ratio was 0.83 [95% confidence interval (CI) 0.78-0.88] in the model data set and 0.86 (95% CI 0.80-0.91) in the validation data set. The AUC for the lateral FTP ratio was 0.82 (95% CI 0.77-0.87) in the model data set and 0.82 (95% CI 0.75-0.88) in the validation data set. The previously established AP FTP cutoff ratio of 0.61 had a 94% negative predictive value in the model cohort and a 100% negative predictive value in the validation cohort.Conclusion:The FTP ratio is an effective and externally validated screening tool to rule out DIA in distal tibia shaft fractures.Level of Evidence:Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Original language | English (US) |
---|---|
Pages (from-to) | 479-484 |
Number of pages | 6 |
Journal | Journal of orthopaedic trauma |
Volume | 35 |
Issue number | 9 |
DOIs | |
State | Published - Sep 1 2021 |
Keywords
- RIDEFAST
- intra-articular extension
- plafond
- posterior malleolus
- spiral
- tibial shaft
ASJC Scopus subject areas
- Surgery
- Orthopedics and Sports Medicine