Assessment of the AO/ASIF fracture classification for the distal tibia
Assessment of the AO/ASIF fracture classification for the distal tibia
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DOI：
10.1097/00005131-199710000-00004
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发表时间：
1997-10-01
影响因子：
2.3
通讯作者：
Brandser, EA
中科院分区：
文献类型：
--
作者：
Martin, JS;Marsh, JL;Brandser, EA
目的：本研究的目的是评估AO/ASIF、Ruedi和Allgower分类对胫骨远端骨折的观察者之间的可靠性和观察者内部的可重复性，并确定计算机断层扫描（CT）扫描的益处和观察者对几种骨折特征（包括分类）的一致意见。方法：对43例胫骨远端骨折的x线片进行评估，其中14例有CT扫描，由经验丰富和经验不足的观察者组进行评估。每个病例根据AO/ASIF和Ruedi和Allgower系统进行分类。还评估了其他几种骨折特征。计算一致性的kappa系数，并用于比较观察者之间的可靠性和观察者内部的可重复性的分类系统，并确定经验和CT扫描的好处。用类内相关系数评价非分类资料。结果：在将骨折分为AO/ASIF类型时，观察者之间和观察者内部的一致性较好，明显优于Ruedi和Allgower系统。然而，在将骨折分为AO/ASIF组时，一致性很差。在大多数评估中，经验丰富的小组往往有更高水平的观察者之间的一致性，而不是观察者内部的一致性。查看CT扫描提高了关节面受累百分比的一致性，但它并没有提高观察者之间的可靠性或观察者内部的可重复性。结论：AO/ASIF对胫骨远端骨折的分类在类型水平上具有良好的观察一致性，但在组水平上一致性较差。经验倾向于改善观察者之间的一致，而不是观察者内部的一致。观察CT扫描不能提高分类的一致性，但它倾向于提高关节面受累的一致性。
Objectives: The purpose of this study was to assess the interobserver reliability and intraobserver reproducibility of the AO/ASIF and Ruedi and Allgower classifications for fractures of the distal tibia, and to determine the benefit of a computed tomography (CT) scan and experience on observer agreement for several fracture characteristics, including classification.Methods: The radiographs of forty-three fractures of the distal tibia, fourteen of which had CT scans, were assessed by groups of experienced and less-experienced observers. Each case was classified according to the AO/ASIF and Ruedi and Allgower systems. Several other fracture characteristics also were assessed. The kappa coefficient of agreement was calculated and used to compare the interobserver reliability and intraobserver reproducibility of the classification systems and to determine the benefit of experience and CT scans. The intraclass correlation coefficient was used to assess noncategoric data.Results: Interobserver and intraobserver agreements were good when classifying fractures into AO/ASIF types and significantly better than that for the Ruedi and Allgower system. However, agreement was poor when classifying the fractures into AO/ASIF groups. For most assessments, the experienced group tended to have higher levels of interobserver agreement, but not intraobserver agreement. Viewing the CT scans improved agreement on the percentage of articular surface involved, but it did not improve interobserver reliability or intraobserver reproducibility for either of the classification systems.Conclusion: The AO/ASIF classification for fractures of the distal tibia has good observer agreement at the type level, but poor agreement at the group level. Experience tends to improve interobserver agreement, but not intraobserver agreement. Viewing CT scans does not improve agreement on classification, but it tends to improve agreement on articular surface involvement.