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Scapula fractures: interobserver reliability of classification and treatment

Version 2 2024-06-03, 16:36
Version 1 2018-07-09, 14:49
journal contribution
posted on 2024-06-03, 16:36 authored by Valentin Neuhaus, Arjan GJ Bot, Thierry G Guitton, David C Ring, Science of Variation Group, Mahmoud I Abdel-Ghany, Jeffrey Abrams, Joshua M Abzug, Lars E Adolfsson, George W Balfour, H Brent Bamberger, Antonio Barquet, Michael Baskies, W Arnold Batson, Taizoon Baxamusa, Grant J Bayne, Thierry Begue, Michael Behrman, Daphne Beingessner, Jan Biert, Julius Bishop, Mateus Borges Oliveira Alves, Martin Boyer, Drago Brilej, Peter RG Brink, Lance M Brunton, Richard Buckley, Juan Carlos Cagnone, Ryan P Calfee, Luiz Augusto B Campinhos, Charles Cassidy, Louis Catalano, Karel Chivers, Pradeep Choudhari, Matej Cimerman, Joseph M Conflitti, Ralph M Costanzo, Brett D Crist, Brian J Cross, Phani Dantuluri, Michael Darowish, Ramon de Bedout, Thomas DeCoster, David G Dennison, Peter H DeNoble, Gregory DeSilva, Thomas Dienstknecht, Scott F Duncan, Xavier A Duralde, Holger Durchholz, Kenneth Egol, Carl Ekholm, Nelson Elias, John M Erickson, J Daniel Espinosa Esparza, CH Fernandes, Thomas J Fischer, Martin Fischmeister, E Forigua Jaime, Charles L Getz, Richard S Gilbert, Vincenzo Giordano, David L Glaser, Taco Gosens, Michael W Grafe, Jose Eduardo Grandi Ribeiro Filho, Robert RL Gray, Lawrence V Gulotta, Nigel William Gummerson, Eric Mark Hammerberg, Edward Harvey, R Haverlag, Patrick DG Henry, Jonathan L Hobby, Eric P Hofmeister, Thomas Hughes, John Itamura, Peter Jebson, Richard Jenkinson, Kyle Jeray, Christopher M Jones, Jedediah Jones, Axel Jubel, Scott G Kaar, K Kabir, F Thomas D Kaplan, Stephen A Kennedy, Michael W Kessler, Hervey L Kimball, Peter Kloen, Cyrus Klostermann, Georges Kohut, GA Kraan, Anze Kristan, Mark I Loebenberg, Kevin J Malone, L Marsh, Paul A Martineau, John McAuliffe, Iain McGraw, Samir Mehta, Milind Merchant, Charles Metzger, SA Meylaerts, Anna N Miller, Jennifer Moriatis Wolf, Joel Murachovsky, Anand Murthi, Michael Nancollas, Betsy M Nolan, Timothy Omara, Reza Omid, Jose A Ortiz, Joachim P Overbeck, Alberto Pérez Castillo, Rodrigo Pesantez, Daniel Polatsch, G Porcellini, Michael Prayson, M Quell, Matthew M Ragsdell, James G Reid, JM Reuver, Marc J Richard, Martin Richardson, Marco Rizzo, Sergio Rowinski, Jorge Rubio, Carlos G Sánchez Guerrero, Wojciech Satora, Peter Schandelmaier, Johan H Scheer, Andrew Schmidt, Todd A Schubkegel, Leah M Schulte, Evan D Schumer, Benjamin W Sears, Adam B Shafritz, Nicholas L Shortt, Todd Siff, Dario Mejia Silva, Raymond Malcolm Smith, Sander Spruijt, Jason A Stein, Emilija Stojkovska Pemovska, Philipp N Streubel, Carrie Swigart, Marc Swiontkowski, George Thomas, Eric T Tolo, Matthias Turina, Minos Tyllianakis, Michel PJ van den Bekerom, Huub van der Heide, MAJ van de Sande, PV van Eerten, Diederik OF Verbeek, David Victoria Hoffmann, AJH Vochteloo, Robert Wagenmakers, Christopher J Wall, Richard Wallensten, Daniel C Wascher, Lawrence Weiss, J Michael Wiater, Brian PD Wills, Jeffrey Wint, Thomas Wright, Jason P Young, Charalampos Zalavras, Robert D Zura, Karol Zyto
OBJECTIVES: There is substantial variation in the classification and management of scapula fractures. The first purpose of this study was to analyze the interobserver reliability of the OTA/AO classification and the New International Classification for Scapula Fractures. The second purpose was to assess the proportion of agreement among orthopaedic surgeons on operative or nonoperative treatment. DESIGN: Web-based reliability study. SETTING: Independent orthopaedic surgeons from several countries were invited to classify scapular fractures in an online survey. PARTICIPANTS: One hundred three orthopaedic surgeons evaluated 35 movies of three-dimensional computerized tomography reconstruction of selected scapular fractures, representing a full spectrum of fracture patterns. MAIN OUTCOME MEASUREMENTS: Fleiss kappa (κ) was used to assess the reliability of agreement between the surgeons. RESULTS: The overall agreement on the OTA/AO classification was moderate for the types (A, B, and C, κ = 0.54) with a 71% proportion of rater agreement (PA) and for the 9 groups (A1 to C3, κ = 0.47) with a 57% PA. For the New International Classification, the agreement about the intraarticular extension of the fracture (Fossa (F), κ = 0.79) was substantial and the agreement about a fractured body (Body (B), κ = 0.57) or process was moderate (Process (P), κ = 0.53); however, PAs were more than 81%. The agreement on the treatment recommendation was moderate (κ = 0.57) with a 73% PA. CONCLUSIONS: The New International Classification was more reliable. Body and process fractures generated more disagreement than intraarticular fractures and need further clear definitions.

History

Journal

Journal of orthopaedic research

Volume

28

Pagination

124-129

Location

Philadelphia, Pa.

eISSN

1531-2291

Language

eng

Publication classification

C1 Refereed article in a scholarly journal

Issue

3

Publisher

Wolter Kluwer

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