Are distal radius fracture classifications reproducible? Intra and interobserver agreement

Belloti, João Carlos; Tamaoki, Marcel Jun Sugawara; Franciozi, Carlos Eduardo da Silveira; Santos, João Baptista Gomes dos; Balbachevsky, Daniel; Chap, Eduardo Chap; Albertoni, Walter Manna; Faloppa, Flávio

doi:10.1590/s1516-31802008000300008

Cited by 64 publications

(75 citation statements)

References 26 publications

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“…4 A reliable distal radius fracture classification is necessary for systematic treatment of these fractures and is essential for comparing the results from different clinical studies. 12,13,15,19,31,32 In the present study, the intraobserver and interobserver reproducibility of the IDEAL classification was generally higher than that of the established classifications. We believe that this classification system is more reliable because of clearness in assessing the classification features.…”

Section: Discussioncontrasting

confidence: 58%

“…An effective classification system must be valid, reliable and reproducible, but it should also standardize a language for consistent communication, provide guidelines for appropriate treatment, indicate the likelihood of complications and fracture instability and predict a realistic prognosis for each fracture. 15 The system should also provide a mechanism for evaluating and comparing treatment results with results from similar fractures in different centers reported at different times. 16,17 Currently, none of the classification systems available have reproducibility that adequately provides evidence for treatment and prognosis.…”

Section: Introductionmentioning

confidence: 99%

“…16,17 Currently, none of the classification systems available have reproducibility that adequately provides evidence for treatment and prognosis. 13,15,18,19 …”

Section: Introductionmentioning

confidence: 99%

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The IDEAL classification system: a new method for classifying fractures of the distal extremity of the radius description and reproducibility

et al. 2013

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The IDEAL classification system: a new method for classifying fractures of the distal extremity of the radiusdescription and reproducibility ABSTRACTCONTEXT AND OBJECTIVE: There is no consensus concerning which classification for distal radius fractures is best and the existing methods present poor reproducibility. This study aimed to describe and assess the reproducibility of the new IDEAL classification, and to compare it with widely used systems. DESIGN AND SETTING: Reproducibility study, Hand Surgery Section, Universidade Federal de São Paulo. METHODS:The IDEAL classification and its evidence-based rationale are presented. Sixty radiographs (posteroanterior and lateral) from patients with distal radius fractures were classified by six examiners: a hand surgery specialist, a hand surgery resident, an orthopedic generalist, an orthopedic resident and two medical students. Each of them independently assessed the radiographs at three different times. We compared the intra and interobserver concordance of the IDEAL, AO, Frykman and Fernandez classifications using Cohen's kappa (κ) (for two observers) and Fleiss's κ (for more than two observers). CONCLUSION:The reproducibility of the IDEAL classification was better than that of the other systems analyzed, thus making the IDEAL system suitable for application. Complementary studies will confirm whether this classification system makes adequate predictions for therapy and prognosis.

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Section: Discussioncontrasting

confidence: 58%

Section: Introductionmentioning

confidence: 99%

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The IDEAL classification system: a new method for classifying fractures of the distal extremity of the radius description and reproducibility

et al. 2013

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“…Although this matter had previously been evaluated in concordance studies involving fracture classifications, it had not been done in studies measuring patellar height (28) . The reliability of the IS and CD indices was congruent with what is seen in the literature, which strengthens our results.…”

Section: Discussionmentioning

confidence: 99%

Avaliação dos métodos de mensuração da altura patelar na radiografia digital

Gracitelli¹,

Pierami²,

Tonelli³

et al. 2012

Rev. bras. ortop.

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Objective: To analyze the most common methods for measuring patellar height and the impact of observer experience in correlations with the other observers using digital radiography. Methods: Sixty digital radiographs of the knee in lateral view were analyzed by four observers: a physician in the second year of medical residence in orthopedics (R2); a physician in the third year of medical residence in orthopedics (R3); an orthopedic surgeon who was a specialist in knee surgery (SK); and a radiologist who was a specialist in musculoskeletal radiology (SR). The indices used were: Insall-Salvati (IS), Blackburne--Peel (BP), Caton-Deschamps (CD) and modified Insall-Salvati

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“…It has shown fair to moderate reliability (k = 0.226-0.41) but fair to substantial reproducibility (k = 0.49-0.621). 7,20,21 Conclusion Classification systems in their most useful form can be tools for succinct rapid communication in clinical contexts between healthcare professionals. Further, when they elude to treatment, recovery or prognosis, they become an invaluable tool for a clinician and can often guide or polarise treatment strategy.…”

Section: Universal (1993)mentioning

confidence: 99%

Adult distal radius fractures classification systems: essential clinical knowledge or abstract memory testing?

Shehovych

Salar

Meyer

et al. 2016

annals

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Classification systems should be tools for concise communication, which ideally can predict prognosis and guide treatment. They should be relevant, reproducible, reliable, properly validated and most importantly simple to use and understand. There are 15 described distal radius classification systems present in the literature in the past 70 years, of which 8 are discussed in this paper. For each classification, we give an insight into its history, strengths and weaknesses, and provide evidence from the literature on reliability and reproducibility.Sadly, on completion of this paper we have not found a distal radius fracture classification that proved to be useful. Failings range from poor reproducibility and reliability, and over-complexity mainly emanating from the inability to classify this spectrum of injury in all of its manifestations. Consequently, we would suggest that classification systems for acute adult distal radius fractures are not useful clinical knowledge but mainly historical and/or research tools. Moreover, we would discourage trainees from spending time learning these classifications, as they serve not as essential clinical knowledge but more as forms of abstract memory testing.

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Are distal radius fracture classifications reproducible? Intra and interobserver agreement

Cited by 64 publications

References 26 publications

The IDEAL classification system: a new method for classifying fractures of the distal extremity of the radius description and reproducibility

The IDEAL classification system: a new method for classifying fractures of the distal extremity of the radius description and reproducibility

Avaliação dos métodos de mensuração da altura patelar na radiografia digital

Adult distal radius fractures classification systems: essential clinical knowledge or abstract memory testing?

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