Slightly higher agreement found with modified vs standard RUST score for metadiaphyseal fractures

By Casey Tingle

Compared with the standard radiographic union scale for tibia score, a modified score for this scale showed slightly higher intraclass correlation coefficients and had substantial agreement for the evaluation of metadiaphyseal fractures.

In the first part of the study, 12 orthopedic trauma surgeons used a modified radiographic union scale for tibia (RUST) score to evaluate the radiographs of 27 distal femur fractures treated with either with plate or retrograde nail fixation. The radiographs were taken at various stages of healing, and the surgeons were given the radiographs in random order and asked to determine fracture healing.

In the second part of the study, researchers reviewed the radiographic results of two multicenter, randomized trials that compared plate and nail fixation of 81 distal femur and 46 proximal tibia fractures. Using the modified RUST score, radiographs were scored by orthopedic surgeons at 24 trauma centers at 3 months, 6 months and 12 months postoperatively to determine fracture healing.


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