Georgios Arealis1, Ilias Galanopoulos2, Vassilios S Nikolaou3, Andrew Lacon4, Neil Ashwood5, Christos Kitsis6. 1. Orthopedic Department, Queen's Hospital, Burton on Trent, UK. Electronic address: garealis@yahoo.gr. 2. 1st Department of Orthopaedics, 401 Military Hospital, Athens, Greece. Electronic address: galanop.ilias@gmail.com. 3. 2nd Department of Orthopaedics, School of Medicine, Athens University, Athens, Greece. Electronic address: vassilios.nikolaou@gmail.com. 4. Orthopedic Department, Queen's Hospital, Burton on Trent, UK. Electronic address: andrewlacon@gmail.com. 5. Orthopedic Department, Queen's Hospital, Burton on Trent, UK. Electronic address: Neil.Ashwood@burtonft.nhs.uk. 6. Orthopedic Department, Queen's Hospital, Burton on Trent, UK. Electronic address: Christos.Kitsis@burtonft.nhs.uk.
Abstract
INTRODUCTION: Distal radius fractures are very common upper limb injuries irrespective of the patient's age. The aim of our study is to evaluate the reliability of the three systems that are often used for their classification (AO - Arbeitsgemeinschaft für Osteosynthesefragen/Association for the Study of Internal Fixation, Fernandez and Universal) and to assess the need for computed tomography (CT) scan to improve inter- and intra-observer agreement. MATERIALS AND METHODS: Five orthopaedic surgeons and two hand surgeons classified radiographs and CT scans of 26 patients using the Fernandez, AO and Universal systems. All data were recorded using MS Excel and Kappa statistics were performed to determine inter- and intra-observer agreement and to evaluate the role of CT scan. RESULTS: Fair-to-moderate inter-observer agreement was noted with the use of X-rays for all classification systems. Intra-observer reproducibility did not improve with the addition of CT scans, especially for the senior hand surgeons. CONCLUSIONS: The agreement rates observed in the present study show that currently there is no classification system that is fully reproducible. Adequate experience is required for the assessment and treatment of these injuries. CT scan should be requested only by experienced hand surgeons in order to help guide treatment, as it does not significantly improve inter- and intra-observer agreement for all classification systems.
INTRODUCTION: Distal radius fractures are very common upper limb injuries irrespective of the patient's age. The aim of our study is to evaluate the reliability of the three systems that are often used for their classification (AO - Arbeitsgemeinschaft für Osteosynthesefragen/Association for the Study of Internal Fixation, Fernandez and Universal) and to assess the need for computed tomography (CT) scan to improve inter- and intra-observer agreement. MATERIALS AND METHODS: Five orthopaedic surgeons and two hand surgeons classified radiographs and CT scans of 26 patients using the Fernandez, AO and Universal systems. All data were recorded using MS Excel and Kappa statistics were performed to determine inter- and intra-observer agreement and to evaluate the role of CT scan. RESULTS: Fair-to-moderate inter-observer agreement was noted with the use of X-rays for all classification systems. Intra-observer reproducibility did not improve with the addition of CT scans, especially for the senior hand surgeons. CONCLUSIONS: The agreement rates observed in the present study show that currently there is no classification system that is fully reproducible. Adequate experience is required for the assessment and treatment of these injuries. CT scan should be requested only by experienced hand surgeons in order to help guide treatment, as it does not significantly improve inter- and intra-observer agreement for all classification systems.
Authors: Valdênia das Graças Nascimento; Antonio Carlos da Costa; Diego Figueira Falcochio; Leonardo Depiere Lanzarin; Sérgio Luiz Checchia; Ivan Chakkour Journal: Hand (N Y) Date: 2015-06-04
Authors: Daniel Gonçalves Machado; Sergio Auto da Cruz Cerqueira; Alexandre Fernandes de Lima; Marcelo Bezerra de Mathias; José Paulo Gabbi Aramburu; Rodrigo Ribeiro Pinho Rodarte Journal: Rev Bras Ortop Date: 2016-01-21
Authors: Ydo V Kleinlugtenbelt; Sylvester R Groen; S John Ham; Peter Kloen; Robert Haverlag; Maarten P Simons; Vanessa A B Scholtes; Mohit Bhandari; J Carel Goslings; Rudolf W Poolman Journal: Acta Orthop Date: 2017-06-14 Impact factor: 3.717
Authors: Valdênia DAS Graças Nascimento; Antonio Carlos DA Costa; Leandro Rodrigues DA Silva; Diego Figueira Falcocchio; Ivan Chakkour; Sergio Luiz Checchia Journal: Acta Ortop Bras Date: 2018 Jan-Feb Impact factor: 0.513
Authors: Alysson Figueiredo Nogueira; Lucas Moratelli; Marcela Dos Santos Martins; Ricardo Torres Iupi; Marcos Felipe Marcatto de Abreu; João Carlos Nakamoto Journal: Acta Ortop Bras Date: 2019 Jul-Aug Impact factor: 0.513
Authors: Anne M Daniels; Luuk M A Theelen; Caroline E Wyers; Heinrich M J Janzing; Bert van Rietbergen; Lisanne Vranken; Robert Y van der Velde; Piet P M M Geusens; Sjoerd Kaarsemaker; Martijn Poeze; Joop P van den Bergh Journal: J Orthop Res Date: 2019-04-24 Impact factor: 3.494