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Andrew Schneider


OBJECTIVE: Aseptic non-union is a significant complication in approximately 5% of long bone fractures1. Bone stimulation devices are used before surgical intervention and can have favorable results if accurately placed. The objective of this study is to determine accuracy of clinician fracture localization based solely on viewing radiographs.

METHODS: A transverse diaphyseal fracture was induced in a cadaveric radius and tibia using a bone saw and osteotome; fractures were not apparent from incision or soft tissue. The sample included 20 physicians and 16 pre-clinical medical students. Participants used reference anteroposterior (AP) and lateral radiographs to determine fracture location and placed a radiopaque marker on cadaver, no palpation was allowed. Repeat AP radiographs of each participant’s placed marker were obtained.

RESULTS: On the radius 70% of physicians and 69% of medical students placed the marker within 1.7 cm. On the tibia, 80% of physicians and 75% of medical students placed the marker within therapeutic limits. Outside of the 1.7 cm, physician average distance was closer to the fracture than the medical student average. Overall, neither physicians nor medical students were significantly more inaccurate for the radius vs. tibia.