{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T13:45:04Z","timestamp":1784900704972,"version":"3.55.0"},"reference-count":15,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2022,5,3]],"date-time":"2022-05-03T00:00:00Z","timestamp":1651536000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Shoulder & Elbow"],"published-print":{"date-parts":[[2023,8]]},"abstract":"\n Background<\/jats:title>\n Early diagnosis and fixation of fractures unlikely to unite can prevent months of morbidity. The Radiographic Union Score for Humeral fractures (RUSHU) is a summative scoring system developed to aid identification of patients at higher risk of developing humeral shaft non-union. Plain radiographs taken six weeks after injury are given a score between four and 12 based on signs of union. Our aim was to assess the validity of the RUSHU prognostic model in an external population.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The radiographs of fifty-seven patients were scored independently according to RUSHU methodology by three reviewers (blinded to patient outcome). Interobserver intraclass correlation (ICC) was calculated.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of the cohort, six (10.5%) progressed to non-union after six months. We observed an interobserver ICC co-efficient of 0.89 (95%CI0.84,0.93) in RUSHU score at six weeks. Median score was significantly higher in the union cohort (10v5 p\u2009<\u20090.001). Using the score of < 8 to predict non-union gave an area under the ROC curve of 0.87 (95%CI 0.83,0.90).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In this retrospective single-centre study, we have demonstrated good inter-rater reliability. We would suggest that the RUSHU model be assessed in further external validation studies. RUSHU has the potential to reduce morbidity of delayed treatment of non-union.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/17585732221097092","type":"journal-article","created":{"date-parts":[[2022,5,3]],"date-time":"2022-05-03T12:05:33Z","timestamp":1651579533000},"page":"390-397","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Validation of the Radiographic Union Score for HUmeral fractures (RUSHU):\n A retrospective study in an independent centre<\/i>"],"prefix":"10.1177","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6837-3589","authenticated-orcid":false,"given":"William","family":"Fordyce","sequence":"first","affiliation":[{"name":"Trauma and Orthopaedics, Derriford Hospital, University Hospitals Plymouth NHS Trust, Plymouth, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Trauma and Orthopaedics, Derriford Hospital, University Hospitals Plymouth NHS Trust, Plymouth, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3781-1133","authenticated-orcid":false,"given":"James R","family":"Allen","sequence":"additional","affiliation":[{"name":"Trauma and Orthopaedics, Derriford Hospital, University Hospitals Plymouth NHS Trust, Plymouth, UK"},{"name":"Trauma and Orthopaedics, Huddersfield Royal Infirmary, Huddersfield, HD3 3EA, UK of Great Britain and Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3627-6434","authenticated-orcid":false,"given":"Mohamed","family":"Abdelmonem","sequence":"additional","affiliation":[{"name":"Trauma and Orthopaedics, Derriford Hospital, University Hospitals Plymouth NHS Trust, Plymouth, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0090-1012","authenticated-orcid":false,"given":"Jonathan","family":"Evans","sequence":"additional","affiliation":[{"name":"Health Services and Policy Research, University of Exeter Medical School, Smeall Building St Luke\u2019s Campus, Exeter EX2 4SG, UK of Great Britain and Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan Thomas","family":"Evans","sequence":"additional","affiliation":[{"name":"University of Bristol, Bristol, UK of Great Britain and Northern Ireland"},{"name":"Torbay and South Devon NHS Foundation Trust, Torquay, Torbay, UK of Great Britain and Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Guyver","sequence":"additional","affiliation":[{"name":"Trauma and Orthopaedics, Derriford Hospital, University Hospitals Plymouth NHS Trust, Plymouth, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,5,3]]},"reference":[{"key":"bibr1-17585732221097092","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2006.04.130"},{"key":"bibr2-17585732221097092","first-page":"1300","volume":"101","author":"Ekholm R","year":"2019","journal-title":"Bone Joint 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