Scapula fractures: interobserver reliability of classification and treatment Journal Article uri icon
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abstract

  • 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.

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    authors
  • Neuhaus, V.
  • Bot, A. G.
  • Guitton, T. G.
  • Ring, D. C.
  • Abdel-Ghany, M. I.
  • Abrams, J.
  • Abzug, J. M.
  • Adolfsson, L. E.
  • Balfour, G. W.
  • Bamberger, H. B.
  • Barquet, A.
  • Baskies, M.
  • Batson, W. A.
  • Baxamusa, T.
  • Bayne, G. J.
  • Begue, T.
  • Behrman, M.
  • Beingessner, D.
  • Biert, J.
  • Bishop, J.
  • Alves, M. B.
  • Boyer, M.
  • Brilej, D.
  • Brink, P. R.
  • Brunton, L. M.
  • Buckley, R.
  • Cagnone, J. C.
  • Calfee, R. P.
  • Campinhos, L. A.
  • Cassidy, C.
  • Catalano, L.
  • Chivers, K.
  • Choudhari, P.
  • Cimerman, M.
  • Conflitti, J. M.
  • Costanzo, R. M.
  • Crist, B. D.
  • Cross, B. J.
  • Dantuluri, P.
  • Darowish, M.
  • de Bedout, R.
  • DeCoster, T.
  • Dennison, D. G.
  • DeNoble, P. H.
  • DeSilva, G.
  • Dienstknecht, T.
  • Duncan, S. F.
  • Duralde, X. A.
  • Durchholz, H.
  • Egol, K.
  • Ekholm, C.
  • Elias, N.
  • Erickson, J. M.
  • Esparza, J. D.
  • Fernandes, C. H.
  • Fischer, T. J.
  • Fischmeister, M.
  • Forigua Jaime, E.
  • Getz, C. L.
  • Gilbert, R. S.
  • Giordano, V.
  • Glaser, D. L.
  • Gosens, T.
  • Grafe, M. W.
  • Filho, J. E.
  • Gray, R. R.
  • Gulotta, L. V.
  • Gummerson, N. W.
  • Hammerberg, E. M.
  • Harvey, E.
  • Haverlag, R.
  • Henry, P. D.
  • Hobby, J. L.
  • Hofmeister, E. P.
  • Hughes, T.
  • Itamura, J.
  • Jebson, P.
  • Jenkinson, R.
  • Jeray, K.
  • Jones, C. M.
  • Jones, J.
  • Jubel, A.
  • Kaar, S. G.
  • Kabir, K.
  • Kaplan, F. T.
  • Kennedy, S. A.
  • Kessler, M. W.
  • Kimball, H. L.
  • Kloen, P.
  • Klostermann, C.
  • Kohut, G.
  • Kraan, G. A.
  • Kristan, A.
  • Loebenberg, M. I.
  • Malone, K. J.
  • Marsh, L.
  • Martineau, P. A.
  • McAuliffe, J.
  • McGraw, I.
  • Mehta, S.
  • Merchant, M.
  • Metzger, C.
  • Meylaerts, S. A.
  • Miller, A. N.
  • Wolf, J. M.
  • Murachovsky, J.
  • Murthi, A.
  • Nancollas, M.
  • Nolan, B. M.
  • Omara, T.
  • Omid, R.
  • Ortiz, J. A.
  • Overbeck, J. P.
  • Castillo, A. P.
  • Pesantez, R.
  • Polatsch, D.
  • Porcellini, G.
  • Prayson, M.
  • Quell, M.
  • Ragsdell, M. M.
  • Reid, J. G.
  • Reuver, J. M.
  • Richard, M. J.
  • Richardson, M.
  • Rizzo, M.
  • Rowinski, S.
  • Rubio, J.
  • Guerrero, C. G.
  • Satora, W.
  • Schandelmaier, P.
  • Scheer, J. H.
  • Schmidt, A.
  • Schubkegel, T. A.
  • Schulte, L. M.
  • Schumer, E. D.
  • Sears, B. W.
  • Shafritz, A. B.
  • Shortt, N. L.
  • Siff, T.
  • Silva, D. M.
  • Smith, R. M.
  • Spruijt, S.
  • Stein, J. A.
  • Pemovska, E. S.
  • Streubel, P. N.
  • Swigart, C.
  • Swiontkowski, Marc F., MD
  • Thomas, G.
  • Tolo, E. T.
  • Turina, M.
  • Tyllianakis, M.
  • van den Bekerom, M. P.
  • van der Heide, H.
  • van de Sande, M. A.
  • van Eerten, P. V.
  • Verbeek, D. O.
  • Hoffmann, D. V.
  • Vochteloo, A. J.
  • Wagenmakers, R.
  • Wall, C. J.
  • Wallensten, R.
  • Wascher, D. C.
  • Weiss, L.
  • Wiater, J. M.
  • Wills, B. P.
  • Wint, J.
  • Wright, T.
  • Young, J. P.
  • Zalavras, C.
  • Zura, R. D.
  • Zyto, K.
    • publication date
  • 2014
    • published in
    Research
    keywords
  • Fractures
  • Injuries
  • Orthopedics
  • Radiography
  • Shoulder
  • Surgery
    • Additional Document Info
    volume
  • 28
    • issue
  • 3