A new study published in the Journal of Pediatric Orthopedics evaluated the reliability of modified radiographic union score for tibial fractures (RUST) in the reduction of tibias of patients with osteogenesis imperfecta (OI).

This study entailed scoring of tibial radiographs of 30 patients with OI fractures or osteotomies. Here, each of the four cortices was given a score as follows—1=no callus, 2=callus present, 3=bridging callus and 4=remodeled and fracture not visible—and the modified RUST was calculated, as a sum of these scores.

The interobserver reliability for the first iteration of scores was found to be 0.926 and for the second series, it was 0.915. The intraobserver reliability for each of the three reviewers for measurements in series 1 and 2 were 0.860, 0.994, and 0.974.

From the findings, it was concluded that the modified RUST has excellent interobserver and intraobserver reliability in OI despite challenges related to the poor quality of the bone and its dysplastic nature.

Source: Franzone J, Finkelstein M, Rogers K, Kruse R. Evaluation of Fracture and Osteotomy Union in the Setting of Osteogenesis Imperfecta. Journal of Pediatric Orthopaedics. 2019;40(1):48-52. doi:10.1097/bpo.0000000000001068