Validation of the modified radiographic union score for tibia fractures (mRUST) in murine femoral fractures

Alentado, Vincent J.; Knox, Adam M.; Staut, Caio A.; McGuire, Anthony C.; Chitwood, Joseph R.; Mostardo, Sarah L.; Shaikh, Mustufa Z.; Blosser, Rachel J.; Dadwal, Usashi C.; Chu, Tien-Min Gabriel; Collier, Christopher D; Li, Jiliang; Liu, Ziyue; Kacena, Melissa A.; Natoli, Roman M.

doi:10.3389/fendo.2022.911058

Cited by 5 publications

(2 citation statements)

References 29 publications

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“…Healing success was assessed using the modified Radiographic Union Score for Tibia, or modified Radiological Union Scale for Tibia (mRUST) fractures, an established and validated score that judges the bridging and fracture line (from 4—no bridging to 16—complete consolidation at each cortical and two planes) of the fracture of tibia or femur by a radiologist blinded for time points and clinical information ( Fiset et al, 2018 ; Mitchell et al, 2019 ; Plumarom et al, 2021 ; Alentado et al, 2022 ; Schmidt et al, 2022 ).…”

Section: Methodsmentioning

confidence: 99%

Lower-limb internal loading and potential consequences for fracture healing

Heyland,

Deppe,

Reisener

et al. 2023

Front. Bioeng. Biotechnol.

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Introduction: Mechanical loading is known to determine the course of bone fracture healing. We hypothesise that lower limb long bone loading differs with knee flexion angle during walking and frontal knee alignment, which affects fracture healing success.Materials and methods: Using our musculoskeletal in silico modelling constrained against in vivo data from patients with instrumented knee implants allowed us to assess internal loads in femur and tibia. These internal forces were associated with the clinical outcome of fracture healing in a relevant cohort of 178 extra-articular femur and tibia fractures in patients using a retrospective approach.Results: Mean peak forces differed with femoral compression (1,330–1,936 N at mid-shaft) amounting to about half of tibial compression (2,299–5,224 N). Mean peak bending moments in the frontal plane were greater in the femur (71–130 Nm) than in the tibia (from 26 to 43 Nm), each increasing proximally. Bending in the sagittal plane showed smaller mean peak bending moments in the femur (−38 to 43 Nm) reaching substantially higher values in the tibia (−63 to −175 Nm) with a peak proximally. Peak torsional moments had opposite directions for the femur (−13 to −40 Nm) versus tibia (15–48 Nm) with an increase towards the proximal end in both. Femoral fractures showed significantly lower scores in the modified Radiological Union Scale for Tibia (mRUST) at last follow-up (p < 0.001) compared to tibial fractures. Specifically, compression (r = 0.304), sagittal bending (r = 0.259), and frontal bending (r = −0.318) showed strong associations (p < 0.001) to mRUST at last follow-up. This was not the case for age, body weight, or localisation alone.Discussion: This study showed that moments in femur and tibia tend to decrease towards their distal ends. Tibial load components were influenced by knee flexion angle, especially at push-off, while static frontal alignment played a smaller role. Our results indicate that femur and tibia are loaded differently and thus require adapted fracture fixation considering load components rather than just overall load level.

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Section: Methodsmentioning

confidence: 99%

Lower-limb internal loading and potential consequences for fracture healing

Heyland,

Deppe,

Reisener

et al. 2023

Front. Bioeng. Biotechnol.

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“…Union in this study was assessed on plain radiograph images that were at least 1 year from surgery using the modified Radiographic Union Score for Tibial Fractures (mRUST). Scoring was performed by the principal investigator (mRUST score has been validated for use in assessing femur fracture union treated with intramedullary nails with excellent inter-and intraobserver reliability (8). Weight-bearing status was obtained from the SSD, as information must be inquired about and filled in the SSD during the follow-up of all patients treated for femur fracture using SIGN nails.…”

Section: Study Population Flow Chartmentioning

confidence: 99%

Canal fitting and treatment outcomes of patients treated with sign fin nail at a Tertiary Hospital in Tanzania

Olomi,

Muhamedhussein,

Haonga

2024

E Af Orth Jnl

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Background: The Surgical Implant Generation Network (SIGN) Fin nail is a relatively newer design of intramedullary nails that eliminates the requirement for distal locking. While various factors influencing treatment outcomes with different nail designs have been extensively studied, limited research has focused on the specific implications of using the SIGN Fin nail. Objective: This study aimed to assess the relationship between Fin nail canal fitting and treatment outcomes in femur fractures treated with the SIGN Fin nail at Muhimbili Orthopaedics Institute. Methods: A cross-sectional study was conducted at a tertiary hospital in Tanzania. Patients who underwent femoral fracture fixation with SIGN Fin nails between January 2016 and December 2021 were recruited from the SIGN surgical database. Radiographic measurements were performed using radiant software, fracture union at one year was assessed using the mRUST score, and weight-bearing status at 6 weeks was obtained from patient records. Results: The mean canal diameter was 11.30±1.75 mm, and 82.2% had a canal fill of 80% or more. The reoperation rate was 5.9% (7/118). Although not statistically significant, patients with canal fill less than 80% had a higher rate of reoperation (p = 0.074). The union rate was 84.1% in this study, with a mean mRUST score of 9.4, and those patients with a canal fill of less than 80% were more likely to have nonunion at 1 year (p = 0.028). Pain on weight bearing at 6 weeks was reported by 42.9% (24/118) of participants, and this was significantly associated with canal fitting (p < 0.001). Conclusion: The study found the degree of canal fitting of the Fin nail to be an important factor affecting the outcomes of femoral fractures treated with SIGN Fin nails. A higher degree of canal fill was associated with better pain outcomes and lower nonunion rates.

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