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Scapula fractures: interobserver reliability of classification and treatment
journal contribution
posted on 2014-03-01, 00:00 authored by Valentin Neuhaus, Arjan G J Bot, Thierry G Guitton, David C Ring, Science of Variation Group, Mahmoud I Abdel-Ghany, Jeffrey Abrams, Joshua M Abzug, Lars E Adolfsson, George W Balfour, H Brent Bamberger, Antonio Barquet, Michael Baskies, W Arnold Batson, Taizoon Baxamusa, Grant J Bayne, Thierry Begue, Michael Behrman, Daphne Beingessner, Jan Biert, Julius Bishop, Mateus Borges Oliveira Alves, Martin Boyer, Drago Brilej, Peter R G Brink, Lance M Brunton, Richard Buckley, Juan Carlos Cagnone, Ryan P Calfee, Luiz Augusto B Campinhos, Charles Cassidy, Louis Catalano, Karel Chivers, Pradeep Choudhari, Matej Cimerman, Joseph M Conflitti, Ralph M Costanzo, Brett D Crist, Brian J Cross, Phani Dantuluri, Michael Darowish, Ramon de Bedout, Thomas DeCoster, David G Dennison, Peter H DeNoble, Gregory DeSilva, Thomas Dienstknecht, Scott F Duncan, Xavier A Duralde, Holger Durchholz, Kenneth Egol, Carl Ekholm, Nelson Elias, John M Erickson, J Daniel Espinosa Esparza, C H Fernandes, Thomas J Fischer, Martin Fischmeister, E Forigua Jaime, Charles L Getz, Richard S Gilbert, Vincenzo Giordano, David L Glaser, Taco Gosens, Michael W Grafe, Jose Eduardo Grandi Ribeiro Filho, Robert R L Gray, Lawrence V Gulotta, Nigel William Gummerson, Eric Mark Hammerberg, Edward Harvey, R Haverlag, Patrick D G Henry, Jonathan L Hobby, Eric P Hofmeister, Thomas Hughes, John Itamura, Peter Jebson, Richard Jenkinson, Kyle Jeray, Christopher M Jones, Jedediah Jones, Axel Jubel, Scott G Kaar, K Kabir, F Thomas D Kaplan, Stephen A Kennedy, Michael W Kessler, Hervey L Kimball, Peter Kloen, Cyrus Klostermann, Georges Kohut, G A Kraan, Anze Kristan, Mark I Loebenberg, Kevin J Malone, L Marsh, Paul A Martineau, John McAuliffe, Iain McGrawOBJECTIVES: 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.
History
Journal
Journal of orthopaedic researchVolume
28Issue
3Pagination
124 - 129Publisher
Wolter KluwerLocation
Philadelphia, Pa.Publisher DOI
eISSN
1531-2291Language
engPublication classification
C1 Refereed article in a scholarly journalUsage metrics
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