Aims and objectives
Hip fractures create a substantial part of the Emergency Rooms (ER) admissions especially for older people.
Diagnosing the fracture site can be difficult without imaging techniques.
Evaluation of the x ray images of anteroposterior (AP) projection of pelvis and proximal femurs need interpretation skills and knowledge.
ER doctors struggle with the initial x-ray images of those patients with suspected hip fractures.
There is usually no radiologist to help for interpretation in early times of the diagnosis.
ER residents need to improve their skills for hip...
Methods and materials
Hip images of anteroposterior radiographs showing both hip joints with or without one-sided fracture of proximal femur including intra capsular and extra capsular pathologies were collected.
X ray image of hips were classified according to their possible evaluation difficulties.
The difficulty degree of the radiographs was graded by an experienced radiologist and an orthopedist with agreement as easy and tough.
Subtle displacement of the fracture borders,
impacted fractures,
suboptimal positioning or suboptimal contrast level due to obesity or underexposure were accepted as possible cause of...
Results
After the first part of education,
the short lecture,
there was no important increase of successful interpretation but significantly increased confidence was detected (Figure 2).
There was decrease in evaluation time spent per image (Figure 3).
Success of interpretation was increased,
evaluation time spent was decrease and confidence of residents was increased statistically significant degree after the detailed education period.
There were 151 successful interpretations of potential 246 patients.
There were 150 successes after the short education period.
For the second part of the education,...
Conclusion
Older people without normal reflexes to protect themselves are more prone to broke proximal femur when fell and hit the floor.
Even if the numbers of femur fractures decrease in developed countries like USA in last 20 years,
it I,s still a problem for community from the protectipn odf older people to diagnose and manage the treatment (1).
Sensitivity of the AP pelvis x-ray images is around 90% in emergency settings.
Additional projections may increase efficiency but difficult to perform in a painful situation.
Pulling...
References
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