Chul-Hyun Cho1, Beom-Soo Kim2, Du-Han Kim2, Chang-Hyuk Choi3, Jinmyoung Dan4, HoMin Lee5. 1. Pain Research Center, Department of Orthopedic Surgery, Dongsan Medical Center, School of Medicine, Keimyung University, 56 Dalseong-ro, Jung-gu, Daegu, South Korea. Electronic address: oscho5362@dsmc.or.kr. 2. Pain Research Center, Department of Orthopedic Surgery, Dongsan Medical Center, School of Medicine, Keimyung University, 56 Dalseong-ro, Jung-gu, Daegu, South Korea. 3. Department of Orthopedic Surgery, Daegu Catholic University Medical Center, Daegu, South Korea. 4. Department of Orthopedic Surgery, Gumi CHA Hospital, CHA University, Gumi, South Korea. 5. Department of Orthopedic Surgery, Gyeongju Hospital, College of Medicine, Dongguk University, Gyeongu, South Korea.
Abstract
INTRODUCTION: Existing various classification systems for distal clavicle fractures have low interobserver and intraobserver reliability and provide limited information for treatment decision. The objective of this study was to determine interobserver and intraobserver reliability of the new classification system and the associated treatment choice for distal clavicle fractures. HYPOTHESIS: The new classification system has good reliability. METHODS: Eight observers including 4 experienced shoulder specialists and 4 orthopedic fellows independently reviewed routine plain radiographs of 74 patients with distal clavicle fractures. They were asked to determine the fracture type according to the new classification system and the treatment choice for each case through web-based survey. Images from each case were randomly presented to the observers in 2 rounds 4 weeks apart. Reliability was assessed on the basis of Fleiss κ values. RESULTS: Interobserver and intraobserver reliability of the classification system were moderate (κ=0.434) and substantial (κ=0.644), respectively. Interobserver and intraobserver reliability of the treatment choice were moderate (κ=0.593) and substantial (κ=0.698), respectively. There were no significant differences in the level of reliability between experienced shoulder specialists and orthopedic fellows for any κ values (all p>0.05). CONCLUSION: Our study demonstrated moderate interobserver and substantial intraobserver reliability of the new classification system and the associated treatment choice for distal clavicle fractures. We believe that our novel classification system will help physicians to choose treatment and implants. LEVEL OF EVIDENCE: III, Cohort study, Diagnosis study.
INTRODUCTION: Existing various classification systems for distal clavicle fractures have low interobserver and intraobserver reliability and provide limited information for treatment decision. The objective of this study was to determine interobserver and intraobserver reliability of the new classification system and the associated treatment choice for distal clavicle fractures. HYPOTHESIS: The new classification system has good reliability. METHODS: Eight observers including 4 experienced shoulder specialists and 4 orthopedic fellows independently reviewed routine plain radiographs of 74 patients with distal clavicle fractures. They were asked to determine the fracture type according to the new classification system and the treatment choice for each case through web-based survey. Images from each case were randomly presented to the observers in 2 rounds 4 weeks apart. Reliability was assessed on the basis of Fleiss κ values. RESULTS: Interobserver and intraobserver reliability of the classification system were moderate (κ=0.434) and substantial (κ=0.644), respectively. Interobserver and intraobserver reliability of the treatment choice were moderate (κ=0.593) and substantial (κ=0.698), respectively. There were no significant differences in the level of reliability between experienced shoulder specialists and orthopedic fellows for any κ values (all p>0.05). CONCLUSION: Our study demonstrated moderate interobserver and substantial intraobserver reliability of the new classification system and the associated treatment choice for distal clavicle fractures. We believe that our novel classification system will help physicians to choose treatment and implants. LEVEL OF EVIDENCE: III, Cohort study, Diagnosis study.
Authors: Andreas Panagopoulos; Konstantina Solou; Irini Tatani; Ioannis K Triantafyllopoulos; John Lakoumentas; Antonis Kouzelis; Vasileios Athanasiou; Zinon T Kokkalis Journal: J Orthop Surg Res Date: 2022-04-07 Impact factor: 2.359