Reliability Of The RUST Score For The Assessment Of Union In Simple Diaphyseal Tibial Fractures.

Objective: The aim of our study is to check the reliability of recently developed Radiographic Union Score for Tibial fractures (RUST Score) for determining the healing progression using X-rays of simple diaphyseal tibial fracture patients.

Methods: Total sixty-five patients with a simple diaphyseal tibial fracture are enrolled. Each of them are regularly follow-up at 6^th, 10^th, 16^th, 20^th, 24^th post fracture weeks as per as their routine treatment protocol. To measure inter-observer reliability, an orthopaedician and a radiologist independently scored the bony union using plain X-ray by RUST scoring method. Further to measure, intra-observer reliability,  each of the radiographs was reassessed and rescored at average of 06^th  weeks, from the initial day of scoring, without revealing patients identity or fracture duration. Finally to check the reliability of RUST score, Intraclass correlation coefficient (ICC) with 95% confidence intervals (CI) was measured.

Results: Overall agreement was statistically significant. The test-retest reliability was statistically significant, having value of 0.87, 0.95, 0.94, 0.98 and 0.97 respectively at each follow-up.  The overall inter as well as intra-observer reliability of RUST score was collectively significant at each follow-up.

Conclusions: The RUST score shows substantial improvements in reliability and produces reproducible results, either scored by an orthopaedican or a radiologist.

RUST Score, Interobserver reliability, Intraobserver reliability, Simple tibial fractures, diaphyseal fracture of tibia.