Janice L Owen1, Derek Stephens, James G Wright. 1. Child Health Evaluative Sciences and the Department of Surgery, The Hospital for Sick Children, Toronto, Ont., Canada.
Abstract
INTRODUCTION: Clinical decisions are based on x-ray measures of radiographs. However, the reliability of assessing the angular measurement of fractured femurs in children is unknown. The purpose of this study was to determine the intra- and interrater reliability of an x-ray assessment of femoral shaft fracture angulation in children. METHODS: On 2 occasions, 3 raters evaluated 30 radiographs of children aged 4 to 10 years, 3 to 24 months after a femoral fracture. The radiographs were evaluated by an orthopedic surgeon, an orthopedic fellow and a research assistant, using a standardized methodology. Reliability was assessed with the intraclass correlation coefficient (ICC), an index of concordance that ranges from 01, where > 0.75 indicates excellent concordance. RESULTS: The ICC for the intrarater ranged from 0.75 to 0.97. The interrater reliability ICC for anterior or posterior angulation was 0.91 (95% confidence interval [CI] 0.840.95) and for varus or valgus angulation was 0.90 (95% CI 0.790.95). A change in measurement of more than 5 degrees exceeds the variation in measurement and, therefore, can be attributed to a true shift in fracture position. CONCLUSIONS: With specific standardized protocols, radiographic assessment of femoral fractures is reliable, irrespective of the examiner's level of experience.
RCT Entities:
INTRODUCTION: Clinical decisions are based on x-ray measures of radiographs. However, the reliability of assessing the angular measurement of fractured femurs in children is unknown. The purpose of this study was to determine the intra- and interrater reliability of an x-ray assessment of femoral shaft fracture angulation in children. METHODS: On 2 occasions, 3 raters evaluated 30 radiographs of children aged 4 to 10 years, 3 to 24 months after a femoral fracture. The radiographs were evaluated by an orthopedic surgeon, an orthopedic fellow and a research assistant, using a standardized methodology. Reliability was assessed with the intraclass correlation coefficient (ICC), an index of concordance that ranges from 01, where > 0.75 indicates excellent concordance. RESULTS: The ICC for the intrarater ranged from 0.75 to 0.97. The interrater reliability ICC for anterior or posterior angulation was 0.91 (95% confidence interval [CI] 0.840.95) and for varus or valgus angulation was 0.90 (95% CI 0.790.95). A change in measurement of more than 5 degrees exceeds the variation in measurement and, therefore, can be attributed to a true shift in fracture position. CONCLUSIONS: With specific standardized protocols, radiographic assessment of femoral fractures is reliable, irrespective of the examiner's level of experience.
Authors: J O Sanders; R H Browne; J F Mooney; E M Raney; B D Horn; D J Anderson; W L Hennrikus; W W Robertson Journal: J Pediatr Orthop Date: 2001 Jul-Aug Impact factor: 2.324
Authors: James G Wright; Elaine E L Wang; Janice L Owen; Derek Stephens; H Kerr Graham; Michael Hanlon; Gary R Nattrass; Rick A K Reynolds; Peter Coyte Journal: Lancet Date: 2005 Mar 26-Apr 1 Impact factor: 79.321
Authors: P C Coyte; S E Bronskill; Z Z Hirji; G Daigle-Takacs; B S Trerise; J G Wright Journal: Clin Orthop Relat Res Date: 1997-03 Impact factor: 4.176
Authors: Justine Tanjaya; Elizabeth L Lord; Chenchao Wang; Yulong Zhang; Jong K Kim; Alan Nguyen; Llyod Baik; Hsin C Pan; Eric Chen; Jin H Kwak; Xinli Zhang; Benjamin Wu; Chia Soo; Kang Ting Journal: Am J Pathol Date: 2017-12-30 Impact factor: 5.770