{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T13:02:02Z","timestamp":1785243722051,"version":"3.55.0"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,5,4]],"date-time":"2021-05-04T00:00:00Z","timestamp":1620086400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,5,4]],"date-time":"2021-05-04T00:00:00Z","timestamp":1620086400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Charit\u00e9"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Musculoskelet Disord"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The aim of the study is to\u00a0 assess the diagnostic value of preoperative conventional radiographs for diagnosing infection associated with internal fixation devices.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We prospectively collected data of patients undergoing removal of internal fixation devices for any reason. Infection was diagnosed in case of purulence, sinus tract, positive histopathology and\/or positive peri-implant tissue or sonication fluid culture. In radiographs radiolucent lines, implant breakage or displacement, or periosteal reaction were assessed. White blood cell count (WBC) and serum C-reactive protein (CRP) were determined at admission.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>We included 421 surgeries in 380 patients (median age 53.6\u2009years, range 11\u201398\u2009years), mainly indicated for infection (24.9%), nonunion (20.0%) and symptomatic implants (13.5%). Radiologic signs of infection included radiolucent lines (11.4%); implant breakage (12.4%) or displacement (10.7%); and periosteal reaction (7.1%). Infection was confirmed in 116 cases (27.6%). Only radiolucent lines (OR\u2009=\u20091.86 [95%CI: 1.00\u20133.38]) and periosteal reaction (OR\u2009=\u20092.48 [95%CI: 1.17\u20135.26]) were associated with infection, with a low sensitivity (16.4 and 12.1%, respectively), and high specificity (90.5 and 94.8%, respectively). Preoperative WBC and CRP had a sensitivity of\u00a023.0 and 35.3%, and specificity of\u00a091.7 and 89.5%, respectively.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Radiological signs suggestive of infection were uncommon. Radiolucency and periosteal reaction were associated with infection, though with low sensitivity.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12891-021-04170-3","type":"journal-article","created":{"date-parts":[[2021,5,5]],"date-time":"2021-05-05T05:27:25Z","timestamp":1620192445000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The value of conventional radiographs for diagnosing internal fixation-associated infection"],"prefix":"10.1186","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4080-8886","authenticated-orcid":false,"given":"Cheng","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8011-6684","authenticated-orcid":false,"given":"Nora","family":"Renz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5219-2521","authenticated-orcid":false,"given":"Andrej","family":"Trampuz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7052-1491","authenticated-orcid":false,"given":"Cristina","family":"Ojeda-Thies","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,5,4]]},"reference":[{"issue":"2","key":"4170_CR1","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1016\/j.idc.2017.01.004","volume":"31","author":"CS Simpfendorfer","year":"2017","unstructured":"Simpfendorfer CS. 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Research was performed in accordance with the Declaration of Helsinki and was approved by the local ethics committee in 2014, prior to commencement of the study and inclusion of patients (Ethikkommission der Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Charit\u00e9platz 1, D-10117 Berlin, Germany; Study number EA4\/041\/14). The certificate of approval and an English translation of it are provided as additional documentation in the submission.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Informed consent was obtained from all study participants included in this database study. In the case of minors (age below 18\u2009years), informed consent was obtained from a parent and\/or legal guardian of the participant.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Author COT has received honoraria for speaking at symposia from MBA and AMGEN, and travel assistance from AMGEN and UCB Iberica, none of them related to this work.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"411"}}