Scapula fractures: interobserver reliability of classification and treatment.
Publication/Presentation Date
3-1-2014
Abstract
OBJECTIVES: There is substantial variation in the classification and management of scapula fractures. The first purpose of this study was to analyze the interobserver reliability of the OTA/AO classification and the New International Classification for Scapula Fractures. The second purpose was to assess the proportion of agreement among orthopaedic surgeons on operative or nonoperative treatment.
DESIGN: Web-based reliability study.
SETTING: Independent orthopaedic surgeons from several countries were invited to classify scapular fractures in an online survey.
PARTICIPANTS: One hundred three orthopaedic surgeons evaluated 35 movies of three-dimensional computerized tomography reconstruction of selected scapular fractures, representing a full spectrum of fracture patterns.
MAIN OUTCOME MEASUREMENTS: Fleiss kappa (κ) was used to assess the reliability of agreement between the surgeons.
RESULTS: The overall agreement on the OTA/AO classification was moderate for the types (A, B, and C, κ = 0.54) with a 71% proportion of rater agreement (PA) and for the 9 groups (A1 to C3, κ = 0.47) with a 57% PA. For the New International Classification, the agreement about the intraarticular extension of the fracture (Fossa (F), κ = 0.79) was substantial and the agreement about a fractured body (Body (B), κ = 0.57) or process was moderate (Process (P), κ = 0.53); however, PAs were more than 81%. The agreement on the treatment recommendation was moderate (κ = 0.57) with a 73% PA.
CONCLUSIONS: The New International Classification was more reliable. Body and process fractures generated more disagreement than intraarticular fractures and need further clear definitions.
Volume
28
Issue
3
First Page
124
Last Page
129
ISSN
1531-2291
Published In/Presented At
Neuhaus, V., Bot, A. G., Guitton, T. G., Ring, D. C., Science of Variation Group, Abdel-Ghany, M. I., Abrams, J., Abzug, J. M., Adolfsson, L. E., Balfour, G. W., Bamberger, H. B., Barquet, A., Baskies, M., Batson, W. A., Baxamusa, T., Bayne, G. J., Begue, T., Behrman, M., Beingessner, D., Biert, J., … Zyto, K. (2014). Scapula fractures: interobserver reliability of classification and treatment. Journal of orthopaedic trauma, 28(3), 124–129. https://doi.org/10.1097/BOT.0b013e31829673e2
Disciplines
Medicine and Health Sciences
PubMedID
23629469
Department(s)
Department of Surgery
Document Type
Article