Interobserver reliability of coronoid fracture classification : two-dimensional versus three-dimensional computed tomography

Lindenhovius, Anneluuk, Karanicolas, Paul Jack, Bhandari, Mohit, van Dijk, Niek, Ring, David, Coast Collaborative and Page, Richard 2009, Interobserver reliability of coronoid fracture classification : two-dimensional versus three-dimensional computed tomography, Journal of hand surgery, vol. 34, no. 9, pp. 1640-1646, doi: 10.1016/j.jhsa.2009.07.009.

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Title Interobserver reliability of coronoid fracture classification : two-dimensional versus three-dimensional computed tomography
Author(s) Lindenhovius, Anneluuk
Karanicolas, Paul Jack
Bhandari, Mohit
van Dijk, Niek
Ring, David
Coast Collaborative
Page, RichardORCID iD for Page, Richard
Contributor(s) Page, RichardORCID iD for Page, Richard
Journal name Journal of hand surgery
Volume number 34
Issue number 9
Start page 1640
End page 1646
Total pages 7
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2009-11
ISSN 0363-5023
Keyword(s) computed tomography
Summary Purpose : This study tests the hypothesis that 3-dimensional computed tomography (CT) reconstructions improve interobserver agreement on classification and treatment of coronoid fractures compared with 2-dimensional CT.

Methods : A total of 29 orthopedic surgeons evaluated 10 coronoid fractures on 2 occasions (first with radiographs and 2-dimensional CT and then with radiographs and 3-dimensional CT), separated by a minimum of 2 weeks. Surgeons classified fractures according to the classifications of Regan and Morrey and of O'Driscoll et al., identified specific characteristics, recommended the most appropriate treatment approach, and made treatment recommendations. The kappa multirater measure (κ) was calculated to estimate agreement between observers.

Results : Regardless of the imaging modality used, there was fair to moderate agreement for most of the observations. Three-dimensional CT improved interobserver agreement in Regan and Morrey's classsication (κ3-dimensional = 0.51 vs κ2-dimensional = 0.40; p < .001) and O'Driscoll et al.'s classifications (κ3-dimensional = 0.48 vs κ2-dimensional = 0.42; p = .009). There were trends toward better reliability for 3-dimensional reconstruction in recognition of coronoid tip fractures (κ3-dimensional = 0.19, κ2-dimensional = 0.03; p = .268), comminution (κ3-dimensional = 0.41 vs κ2-dimensional = 0.29; p = .133), and impacted fragments (κ3-dimensional = 0.39 vs κ2-dimensional = 0.27; p = .094), and in surgeons' opinions on the need for something other than screws or plate for surgical fixation (κ3-dimensional = 0.31 vs κ2-dimensional = 0.15; p = .138). Interobserver agreement on treatment approach was better with 2-dimensional CT (κ3-dimensional = 0.27, κ2-dimensional = 0.32; p = .015).

Conclusions :
Three-dimensional CT reconstructions improve interobserver agreement with respect to fracture classification compared with 2-dimensional CT.
Language eng
DOI 10.1016/j.jhsa.2009.07.009
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2009, Elsevier
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Document type: Journal Article
Collections: Faculty of Health
School of Medicine
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