How accurate and reliable are doctors in estimating fracture angulation?

This study assessed the accuracy of doctors in estimating fracture angulation. Radiographs of fractured wrist and forearm of varying angulations were shown to all grades of doctors in the speciality of trauma and orthopaedics. They were asked to estimate the angulation at the fracture site without using a goniometer. The estimates were analysed for accuracy and variability. This study showed that doctors have a mean error of 8-9 degrees and had poor agreement with themselves and others. We recommend the use of a goniometer to assess fracture angulation.