Comparing the accuracy of fracture diagnosis using minimal-resource vs. standard-resource plain radiographs

Abstract

Plain radiographs remain a fundamental diagnostic tool for identifying long bone fractures. In resource-limited settings, adaptation of radiographic methods is essential to ensure diagnostic reliability. This study aimed to compare the accuracy of plain radiograph interpretations performed with minimal resources against those using standard resources, thereby optimizing diagnostic approaches in constrained environments. An observational analytic study with a cross-sectional design was conducted using medical records of extremity fracture patients at Dr. Zainoel Abidin Regional Public Hospital (RSUDZA). Radiographs obtained with minimal resources, either anteroposterior (AP) or lateral (Lat) views, were compared with standard-resource images that combined both views (AP + Lat). Diagnostic test parameters, including accuracy, sensitivity, and specificity, were calculated. Among 55 samples, AP view readings achieved 89.1% accuracy, 95.3% sensitivity, and 80% specificity. Lateral view readings showed 87.3% accuracy, 91.1% sensitivity, and 70% specificity. Standard-resource interpretation provided the highest accuracy at 96.3%. These findings indicate that even in minimal-resource conditions, plain radiographs can yield reasonably reliable diagnostic results, particularly due to their high sensitivity. The study underscores the importance of adapting radiographic protocols in low-resource environments and suggests that simplified methods may serve as effective alternatives. Further research is recommended to validate these findings in larger populations.

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