Radiographic diagnosis of scapholunate dissociation among intra-articular fractures of the distal radius: interobserver reliability

Gradl, Gertraud, Neuhaus, Valentin, Fuchsberger, Thomas, Guitton, Thierry G., Prommersberger, Karl-Josef, Ring, David, Wahegaonkar, Abhijeet L., Shafritz, Adam B., Garcia, Aida E., Caputo, Andrew E., Terrono, Andrew L., Spoor, Andy B., Eschler, Anica, Vochteloo, Anne J. H., Beumer, Annechien, Barquet, Antonio, Kristan, Anze, van der Zwan, Arnard L., Berner, Arne, Ilyas, Asif, Jubel, Axel, Sutker, Ben, Nolan, Betsy M., Petrisor, Brad, Cross, Brian J., Wills, Brian P. D., Page, Richard S. and Science of Variation Group 2013, Radiographic diagnosis of scapholunate dissociation among intra-articular fractures of the distal radius: interobserver reliability, Journal of hand surgery, vol. 38, no. 9, pp. 1685-1690, doi: 10.1016/j.jhsa.2013.05.039.

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Title Radiographic diagnosis of scapholunate dissociation among intra-articular fractures of the distal radius: interobserver reliability
Author(s) Gradl, Gertraud
Neuhaus, Valentin
Fuchsberger, Thomas
Guitton, Thierry G.
Prommersberger, Karl-Josef
Ring, David
Wahegaonkar, Abhijeet L.
Shafritz, Adam B.
Garcia, Aida E.
Caputo, Andrew E.
Terrono, Andrew L.
Spoor, Andy B.
Eschler, Anica
Vochteloo, Anne J. H.
Beumer, Annechien
Barquet, Antonio
Kristan, Anze
van der Zwan, Arnard L.
Berner, Arne
Ilyas, Asif
Jubel, Axel
Sutker, Ben
Nolan, Betsy M.
Petrisor, Brad
Cross, Brian J.
Wills, Brian P. D.
Page, Richard S.ORCID iD for Page, Richard S.
Science of Variation Group
Journal name Journal of hand surgery
Volume number 38
Issue number 9
Start page 1685
End page 1690
Total pages 6
Publisher Elsevier
Place of publication Maryland Heights, Mo.
Publication date 2013-09
ISSN 0363-5023
Keyword(s) interobserver reliability
distal radius intra-articular fracture
scapholunate injury
Intra-Articular Fractures
Ligaments, Articular
Lunate Bone
Observer Variation
Radius Fractures
Reproducibility of Results
Scaphoid Bone
Wrist Injuries
Science of Variation Group
Summary PURPOSE: To evaluate the reliability and accuracy of diagnosis of scapholunate dissociation (SLD) among AO type C (compression articular) fractures of the distal radius.

METHODS: A total of 217 surgeons evaluated 21 sets of radiographs with type C fractures of the distal radius for which the status of the scapholunate interosseous ligament was established by preoperative 3-compartment computed tomographic arthrography with direct operative visualization of diagnosed SLD (reference standard). Observers were asked whether SLD was present, and if yes, whether they would recommend operative treatment. Diagnostic performance characteristics were calculated with respect to the reference standard. We assessed interobserver reliability using the Fleiss generalized kappa.

RESULTS: The interobserver agreement for radiographic diagnosis of SLD was moderate (κ = 0.44). Correct diagnosis for a given set of radiographs ranged from 8% to 98% (average, 79%) of observers. Diagnostic performance characteristics were: 69% sensitivity, 84% specificity, 84% accuracy, 68% positive predictive value, and 84% negative predictive value. Based on a prevalence of 5%, Bayes adjusted positive and negative predictive values were 18% and 98%, respectively. Raters recommended operative treatment in 74% to 100% of patients diagnosed with SLD.

CONCLUSIONS: Radiographs are moderately reliable and are better at ruling out than ruling in SLD associated with type C fracture of the distal radius.
Language eng
DOI 10.1016/j.jhsa.2013.05.039
Field of Research 110399 Clinical Sciences not elsewhere classified
1103 Clinical Sciences
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2013, American Society for Surgery of the Hand
Persistent URL

Document type: Journal Article
Collections: Faculty of Health
School of Medicine
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